{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T21:14:44Z","timestamp":1757625284104,"version":"3.44.0"},"reference-count":18,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:sec>\n              <jats:title>Background<\/jats:title>\n              <jats:p>In the present report, we discuss the clinical and species-specific diagnosis of African tick-bite fever.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n              <jats:title>Case Summary<\/jats:title>\n              <jats:p>\n                A 58-year-old man was admitted to the hospital for fever, headache, and myalgia. The clinical examination yielded only two small purpuric lesions with a dark center on the thigh and the abdomen. The patient reported that he had just returned from a 10-day trip to the eastern region of South Africa, and that he had hiked through the bush in Eswatini 7 days before the onset of fever. The white blood cell count showed lymphopenia, and the C reactive protein and alanine aminotransferase levels were mildly elevated. The diagnoses of bacteremia, malaria, COVID 19, and arboviruses were ruled out. Both the diagnoses of African tick-bite fever and Mediterranean spotted fever were plausible because both\n                <jats:italic toggle=\"yes\">Rickettsia africae<\/jats:italic>\n                and\n                <jats:italic toggle=\"yes\">Rickettsia conorii<\/jats:italic>\n                are present in South Africa. The presence of two skin lesions presumed to be necrotic eschars was a bit more suggestive of African tick-bite fever. Treatment with doxycycline was started once blood serology and a biopsy of the abdominal lesion had been performed. The outcome was rapidly favorable. A PCR assay performed on the abdominal eschar confirmed the involvement of\n                <jats:italic toggle=\"yes\">R. africae,<\/jats:italic>\n                while the successive serological assays did not.\n              <\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n              <jats:title>Conclusion<\/jats:title>\n              <jats:p>Numerous necrotic eschars without secondary maculopapular rash affecting the sole and palms are more commonly observed in African tick-bite fever than in Mediterranean spotted fever.<\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/asmcr.00010-24","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T08:58:44Z","timestamp":1736240324000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Another traveler\u2019s tale: African tick-bite fever"],"prefix":"10.1128","volume":"1","author":[{"given":"A.","family":"Brunet","sequence":"first","affiliation":[{"name":"Unit\u00e9 Post Urgences M\u00e9dicales, H\u00f4pital Robert Debr\u00e9, CHU Reims","place":["Reims, France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Leplatois","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Post Urgences M\u00e9dicales, H\u00f4pital Robert Debr\u00e9, CHU Reims","place":["Reims, France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clement","family":"Lier","sequence":"additional","affiliation":[{"name":"Laboratoire de Virologie, P\u00f4le de Biologie Territoriale","place":["Reims, France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Limelette","sequence":"additional","affiliation":[{"name":"Laboratoire de Bact\u00e9riologie, P\u00f4le de Biologie Territoriale","place":["Reims, France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9092-5071","authenticated-orcid":false,"given":"Y.","family":"N\u2019Guyen","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Post Urgences M\u00e9dicales, H\u00f4pital Robert Debr\u00e9, CHU Reims","place":["Reims, France"]},{"name":"UMR-S 1320 CardioVir, Universit\u00e9 de Reims Champagne Ardenne","place":["Reims, 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