title: African tick bite fever: a not-so-uncommon illness in international travelers.
abstract: BACKGROUND
  African tick bite fever is a rickettsial illness that has recently emerged as a significant disease among international travelers. The vector is the Amblyomma tick, which is endemic to sub-Saharan Africa and parts of the eastern Caribbean.
  
  
  METHODS
  We describe a middle-aged woman who returned from a mission trip to Zimbabwe with an influenzalike illness and inoculation eschar; she also had a history of travel to a game farm. Biopsy revealed a histopathologic pattern consistent with an infectious pathogenesis. Immunohistochemical staining confirmed the presence of rickettsial organisms. In light of the patient's history, the clinical constellation of signs and symptoms, and the results of ancillary laboratory testing, a diagnosis of African tick bite fever was made. The patient was treated with doxycycline hydrochloride and had an uncomplicated course.
  
  
  CONCLUSIONS
  This report further highlights the epidemiological and clinical features of African tick bite fever. With the increase in international travel, it is important to recognize the illness in those who have been to endemic countries and to counsel patients regarding preventive measures for planned travel.
authors.affiliation: Department of Internal Medicine, Division of Dermatology, University of Louisville School of Medicine, Louisville, KY 40292, USA.
authors.forename: Cindy E
authors.initials: CE
authors.lastname: Owen
authors.forename: Soon
authors.initials: S
authors.lastname: Bahrami
authors.forename: Janine C
authors.initials: JC
authors.lastname: Malone
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Callen
authors.forename: Carol L
authors.initials: CL
authors.lastname: Kulp-Shorten
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001096:Arachnid Vectors; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D012282:Rickettsia Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013987:Ticks; D014195:Travel; D014481:United States; D015030:Zimbabwe
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline