- Causes African tick-bite fever (ATBF)
- Carried by Amblyomma hebraeum and A. variegatum ticks in sub-Saharan Africa and the West Indies
- Most frequently-imported rickettsiosis
Clinical Manifestations
- Most common symptoms include fever, headache, and myalgias, with a black eschar ("tache noire")
- Often have regional lymphadenopathy
- Can have multiple eschars
- Rash less common
- Subacute neuropathy
Diagnosis
- Serology is the mainstay of diagnosis, but may need paired acute and convalescent serologies demonstrating a fourfold rise in titres
- Compared to other Rickettsiae, antibodies appear late in convalescence
- May see organism in skin biopsy
- May be able to PCR blood, skin biopsy, or eschar base swabs
Management
