{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:12:41Z","timestamp":1761513161513},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2012,7,12]],"date-time":"2012-07-12T00:00:00Z","timestamp":1342051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> Cutaneous leishmaniasis and rickettsial African tick\u2010bite fever are two zoonoses increasingly diagnosed in industrialized nations due to more international travel to endemic areas.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> A 52\u2010year\u2010old American nurse was evaluated for a 0.5\u2003cm well\u2010demarcated, tender, shallow ulcer on her wrist, nonproductive cough, fever, chills, and night sweats, all of which began three\u2003weeks after travel to Botswana and a visit to a game reserve, where she reported being scratched on the ankle by a cheetah.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> This cutaneous finding was strongly suggestive of leishmaniasis, but the systemic symptoms were perplexing. Although excisional biopsy showed only nonspecific changes, a specimen sent to the United States Centers for Disease Control revealed leishmania promastigotes of <jats:italic>L.\u00a0tropica<\/jats:italic>. Initial <jats:italic>Rickettsia typhi<\/jats:italic> titers and many other serologic tests were negative. However, four\u2003weeks after admission, <jats:italic>R.\u00a0typhi<\/jats:italic> IgG titer was 1\u2003:\u200364 and <jats:italic>R.\u00a0rickettsii<\/jats:italic> IgG was 1\u2003:\u20031024.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Thus, our patient had two tropical diseases simultaneously.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2011.05362.x","type":"journal-article","created":{"date-parts":[[2012,7,13]],"date-time":"2012-07-13T16:00:07Z","timestamp":1342195207000},"page":"960-963","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cutaneous leishmaniasis and rickettsial African tick\u2010bite fever: a combination of exotic traveler\u2019s diseases in the same patient"],"prefix":"10.1111","volume":"51","author":[{"given":"Robert A.","family":"Schwartz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajendra","family":"Kapila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean C.","family":"McElligott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne H.","family":"Atkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. 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