African tick bite fever
| African tick bite fever | |
|---|---|
|
Leg lesion after Rickettsia africae infection | |
| Classification and external resources | |
| Specialty | Infectious disease |
| ICD-10 | A77.8 |
African tick bite fever (ATBF) is a bacterial infection transmitted by ticks in the Amblyomma or the Rhipicephalus genus in sub-Saharan Africa and the West Indies.[1] It is caused by the Rickettsia africae bacterium.[2] The incubation period of the disease is from 5 to 7 days [3] and symptoms include fever, headache and a skin rash. The rash is characterized by scant lesions, often macular and/or vesicular.[4]
Signs and symptoms
Onset of illness is typically 5–7 days after a tick bite.[1] Common presenting symptoms include:
- Fever
- Headache
- Muscle aches
- Inoculation eschar(s)
- Eschars may or may not be present. In ATBF, unlike what is typically seen with other Rickettsial spotted fevers, multiple eschars may be seen. Amblyomma ticks actively attack cattle or humans and can bite more than once.[5]
- Swollen lymph nodes near the site of the bite
- Maculopapular rash[1]
Complications have been reported, however there are no known deaths due to ATBF to date.[5]
Treatment and prevention
African tick bite fever is usually mild, and most patients do not need more than at-home treatment with antibiotics for their illness.[6] However, because so few patients with this infection visit a doctor, the optimal antibiotic choice, dose and length of treatment are not well known.[1] Typically doctors treat this disease with antibiotics that have been used effectively for the treatment of other diseases caused by bacteria of similar species, such as Rocky Mountain Spotted Fever.[1] For mild cases, patients is usually treated with one of the following: doxycycline (100 mg by mouth two times daily for 1–5 days), chloramphenicol (500 mg by mouth three times daily for 7–10 days) or ciprofloxacin (750 mg by mouth two times daily for 5 days).[6]
If patients have more severe symptoms, like a high fever or bad headache, the infection can be treated with doxycycline (100 mg orally two times daily for 7 days).[2]
Pregnant women should not use doxycycline or ciprofloxacin as both antibiotics can cause problems in fetuses.[7] Josamycin has been used effectively for treatment of pregnant women with other rickettsial diseases, but it is unclear if it has a role in their treatment.[2]
See also
References
- 1 2 3 4 5 Parola, Philippe; Paddock, Christopher D.; Socolovschi, Cristina; Labruna, Marcelo B.; Mediannikov, Oleg; Kernif, Tahar; Abdad, Mohammad Yazid; Stenos, John; Bitam, Idir (2013-10-01). "Update on Tick-Borne Rickettsioses around the World: a Geographic Approach". Clinical Microbiology Reviews. 26 (4): 657–702. doi:10.1128/CMR.00032-13. ISSN 0893-8512. PMC 3811236
. PMID 24092850. - 1 2 3 Jensenius M, Fournier PE, Kelly P, Myrvang B, Raoult D (September 2003). "African tick bite fever". Lancet Infect Dis. 3 (9): 557–64. doi:10.1016/S1473-3099(03)00739-4. PMID 12954562.
- ↑ Frean, J.; Blumberg, L.; Ogunbanjo, GA (September 2008). "Tick bite fever in South Africa". South African Family Practice. 50 (2): 33–35. Retrieved 18 May 2012.
- ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1130. ISBN 1-4160-2999-0.
- 1 2 Jeremy Farrar, Peter Hotez, Thomas Junghanss, Gagandeep Kang, David Lalloo, Nicholas J. White (2013). Manson's Tropical Diseases. Elsevier Health Sciences. p. 279. ISBN 9780702051029.
- 1 2 "Chapter 174. Rickettsial Diseases | Harrison's Principles of Internal Medicine, 18e | AccessMedicine | McGraw-Hill Medical". accessmedicine.mhmedical.com. Retrieved 2016-12-01.
- ↑ "Tips From Other Journals - American Family Physician". www.aafp.org. Retrieved 2016-12-02.