Abstract
Background
African tick-bite fever is an increasingly common cause for fever in the returning
traveller. It needs to be considered in the febrile returning traveller with a characteristic
rash: a black eschar.
Case Report
We describe a 51-year-old man returning from South Africa who presented to our emergency
department with fever, headache, myalgia, and chills. On careful history and skin
examination, a black eschar was found on the patient's left lateral shoulder, pointing
toward a diagnosis of African tick-bite fever. The patient was treated with doxycycline
and rapidly improved.
Why Should an Emergency Physician be Aware of This?
In the emergency department, the diagnosis of African tick-bite fever is often overlooked
in the pursuit of ruling out other travel-related illnesses, such as malaria. A thorough
history, a complete physical examination, and a high level of suspicion are essential
to the timely diagnosis and treatment of African tick-bite fever in the returning
traveller.
Keywords
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Article info
Publication history
Published online: October 06, 2017
Accepted:
August 2,
2017
Received in revised form:
June 29,
2017
Received:
May 17,
2017
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
