{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T18:17:49Z","timestamp":1765995469272,"version":"build-2065373602"},"reference-count":17,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T00:00:00Z","timestamp":1731715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Toronto"},{"name":"University Health Network"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Fever in the returning traveler is a medical emergency warranting prompt exclusion of potentially life-threatening infections such as malaria. Case Presentation: We describe a case of a febrile returned traveler to South Africa whose prompt initial diagnostic work-up was notable for a false-positive malaria rapid diagnostic test (RDT), and who nevertheless responded quickly to oral atovaquone-proguanil, despite an ultimate diagnosis of African tick bite fever. Subsequent RDT and malaria thick- and thin-film blood examination failed to corroborate a diagnosis of malaria and all other microbiological testing other than rickettsial serology remained non-contributory. Conclusions: The case presented highlights important points regarding diagnostic test performance characteristics and premature diagnostic closure.<\/jats:p>","DOI":"10.3390\/reports7040100","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T04:07:09Z","timestamp":1731902829000},"page":"100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["False-Positive Malaria Rapid Diagnostic Test Likely Due to African Tick Bite Fever: A Case Report"],"prefix":"10.3390","volume":"7","author":[{"given":"Rahel T.","family":"Zewude","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2488-2696","authenticated-orcid":false,"given":"Syed Zain","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Institute of Medical Science, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4609-0827","authenticated-orcid":false,"given":"Tom","family":"Joseph","sequence":"additional","affiliation":[{"name":"Institute of Medical Science, University of Toronto, Toronto, ON M5T 3M7, Canada"},{"name":"Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea K.","family":"Boggild","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada"},{"name":"Institute of Medical Science, University of Toronto, Toronto, ON M5T 3M7, Canada"},{"name":"Tropical Disease Unit, Toronto General Hospital, Toronto, ON M5G 2C4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,16]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023, November 25). 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Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1056\/NEJMra1508435","article-title":"Approach to Fever in the Returning Traveler","volume":"376","author":"Thwaites","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kavanaugh, M.J., Azzam, S.E., and Rockabrand, D.M. (2021). Malaria Rapid Diagnostic Tests: Literary Review and Recommendation for a Quality Assurance, Quality Control Algorithm. Diagnostics, 11.","DOI":"10.3390\/diagnostics11050768"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s11908-018-0655-4","article-title":"An Update on Malaria Rapid Diagnostic Tests","volume":"20","author":"Mukkala","year":"2018","journal-title":"Curr. Infect. Dis. 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Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1503\/cmaj.070102","article-title":"Tache noire","volume":"178","author":"Daneman","year":"2008","journal-title":"CMAJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/S1473-3099(03)00739-4","article-title":"African tick bite fever","volume":"3","author":"Jensenius","year":"2003","journal-title":"Lancet Infect. Dis."},{"key":"ref_16","first-page":"1343081","article-title":"African tick bite fever in returning Swedish travellers. Report of two cases and aspects of diagnostics","volume":"7","author":"Nilsson","year":"2017","journal-title":"Infect. Ecol. Epidemiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"456","DOI":"10.7326\/0003-4819-158-6-201303190-00005","article-title":"GeoSentinel surveillance of illness in returned travelers, 2007\u20132011","volume":"158","author":"Leder","year":"2013","journal-title":"Ann. Intern. 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