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Rickettsiosis is one of the most common tick-borne infections in sub-Saharan Africa.¹ Mediterranean spotted fever, caused by Rickettsia conorii, is transmitted by the brown dog tick, Rhipicephalus sanguineus. African tick bite fever, caused by Rickettsia africae, is contracted from ticks of cattle and game and is transmitted via Amblyomma ticks.¹ After inoculation, Rickettsiae proliferate intracellularly in the endothelium of blood vessels, and endothelial damage may cause various clinical manifestations. We herein describe 2 cases of spotted-fever group rickettsiosis after return from safari holidays in Swaziland. One patient showed unseal involvement of mucous membranes.

Report of Cases

Case 1. A 67-year-old man presented with a 2-day history of fever, dry cough, rash, and episcleritis (Figure 1). Four days prior to admission, he and his wife had returned from a safari holiday in Swaziland. He reported that he had been bitten by insects while in Mkhaya Game Reserve in . . . [Full Text of this Article]

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AUTHOR INFORMATION
Amanda Swantje Büchau, MD; Jens U. Wurthner, MD, PhD; Julia Reifenberger, MD; Thomas Ruzicka, MD

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