title: Molecular diagnosis of African tick bite fever using eschar swabs in a traveller returning from Tanzania.
abstract: African tick bite fever is an emerging infectious disease among travellers caused by the pathogen Rickettsia africae. Most travel-associated cases have been reported from countries in southern Africa. So far it has rarely been reported among travellers to eastern Africa and our patient is one of the first described cases imported from Tanzania. A woman presented with fever, chills, headache, myalgia and a rickettsial eschar on her ankle after returning from Tanzania. The diagnosis of African tick bite fever is often based on clinical grounds due to a lack of reliable diagnostic tests at commencement of symptoms. In this patient direct molecular detection of R. africae was performed by PCR from a sample obtained non-invasively with a swab from the rickettsial eschar. A positive PCR result was achieved although the patient had already started antibiotic treatment with doxycycline. In conclusion, this non-invasive method enables early diagnosis of African tick bite fever by direct molecular detection of R. africae and might improve the management of undifferentiated fever in travellers from Africa.
authors.affiliation: Department of Medicine I, Division for Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Nicole
authors.initials: N
authors.lastname: Harrison
authors.affiliation: Department of Medicine I, Division for Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Burgmann
authors.affiliation: Department of Medicine I, Division for Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.|Center of Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Forstner
authors.affiliation: Department of Medicine I, Division for Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.|Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
authors.affiliation: Department of Medicine II, Division for Emergency Medicine, SMZ Ost - Donauspital, Vienna, Austria.
authors.forename: Marton
authors.initials: M
authors.lastname: Széll
authors.affiliation: Institute for Hygiene and Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
authors.forename: Anna-Margarita
authors.initials: AM
authors.lastname: Schötta
authors.affiliation: Institute for Hygiene and Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
authors.forename: Gerold
authors.initials: G
authors.lastname: Stanek
authors.affiliation: Institute for Hygiene and Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria. mateusz.markowicz@meduniwien.ac.at.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Markowicz
mesh_terms: D000328:Adult; D001317:Austria; D005260:Female; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000295:instrumentation / Q000379:methods; D016133:Polymerase Chain Reaction / Q000295:instrumentation / Q000379:methods; D012281:Rickettsia / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D012282:Rickettsia Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D012867:Skin / Q000382:microbiology; D013048:Specimen Handling / Q000295:instrumentation / Q000379:methods; D013636:Tanzania; D017282:Tick-Borne Diseases / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D014195:Travel
keywords: African tick bite fever; Eschar; Rickettsia africae; Rickettsiosis; Tanzania