1/3. African tick-bite fever: four cases among Swiss travelers returning from south africa.BACKGROUND: African tick-bite fever (ATBF) is a recently described disease belonging to the spotted fever group. It is caused by rickettsia africae, and cases are mainly diagnosed in travelers returning from sub-Saharan Africa. methods: We report four cases of ATBF among Swiss travelers returning from a 1-month trip in rural south africa. diagnosis was made on the basis of clinical, epidemiologic and serologic findings that we describe in detail. serology was performed using microimmunofluorescence (MIF) assay 2 weeks, 6 weeks and 14 months after the commencement of symptoms. RESULTS: All patients developed the typical eschar and a rash; two had a local lymphadenopathy and one a lymphangitic reaction. Two patients developed transient neuropsychiatric symptoms such as headache, irritability and depressed mood. All four patients had rises in both IgM and IgG classes of anti-R. africae antibodies. After 1 year, only two patients still had measurable circulating antibodies. Cross-reactions with R. conorii were noted. Three patients were cured after a short course of doxycycline; one required 15 days of treatment. CONCLUSIONS: ATBF is a benign disease increasingly being diagnosed in travelers. After ruling out malaria, ATBF diagnosis relies upon a detailed travel history and the classical findings of influenza-like symptoms, fever, one or more necrotic eschars, and rash. serologic tests usually help to confirm the diagnosis. Neuropsychiatric symptoms specifically associated with ATBF are reported here for the first time.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
2/3. Recurrent splinter haemorrhages weeks after a tick bite.A 52-year-old man developed fever, headache, tinnitus, and painful joints. He reported a tick bite contracted during a summer holiday in the netherlands, followed by erythema on his left arm three weeks earlier. Initial treatment with doxycycline had failed and he had now developed signs of meningoencephalitis. Laboratory tests showed an increased white cell count (16.1 x 10(9)/1), and elevated ESR (51/1h).- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
3/3. Not only 'Flinders Island' spotted fever.AIM: To demonstrate that Flinders Island spotted fever (FISF), a spotted fever group rickettsial infection caused by rickettsia honei, is found not only on Flinders Island (bass Strait), tasmania, but elsewhere in south-east Australia. methods: Cases of FISF were identified by rickettsial serology, culture and the detection of rickettsial dna via PCR. Isolates and PCR products were sequenced to identify the aetiological agent as R. honei. RESULTS: Three new cases of FISF were detected outside of Flinders Island. One on Schouten Island, south of the Freycinet Peninsula, tasmania, and two in south-eastern south australia (McLaren Vale and Goolwa). CONCLUSIONS: These cases show that FISF extends beyond Flinders Island and most likely has the same distribution across south-east Australia as its vector, the reptile tick Aponomma hydrosauri. FISF should be considered as a differential diagnosis in patients from south-eastern Australia presenting with fever, headache and rash following a tick bite.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |