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Department of Geriatrics and Internal Medicine, Champmaillot Hospital, University Hospital, Dijon, FranceINSERM/U1093 Motricity-Plasticity, University of Burgundy, Dijon, France
African Rickettsiosis is an endemic zoonosis in Africa and is transmitted by ticks.
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Bites are usually painless and inconspicuous; the incubation period is 5 to 7 days.
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The clinical features associate flu-like syndrome and skin lesions.
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Serological tests become positive after 2 or 3 weeks of evolution.
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In most cases, the spontaneous prognosis (without antibiotic therapy) is favorable.
1. Indication
A 66-year-old man with no particular medical history and back from a 10-day trip to South Africa, consulted for headache, myalgia, odynophagia and low-grade fever (38°), which had lasted for 3 days. The clinical examination revealed several escharotic skin lesions on the anterior left groin (Fig. 1a ) and right ankle (Fig. 1b), which had appeared the day before, without pain or itching. The lesions were surrounded by several erythematous papules. Biological tests showed leukopenia at 3400 cells/mm3 (normal 4000–10,800) with neutropenia at 1300 cells/mm3 (normal 1800–6800), and an increase in aspartate aminotransferase at 199 IU/L (normal 17–59) and alanine aminotransferase at 185 IU/L (normal 21–72).
Fig. 1Skin lesions of African Rickettsiosis on the anterior left groin (a) and the right ankle (b).
]. Clustered cases are frequent. In addition, multiple bites are frequently found in the same person; the bites are usually painless and inconspicuous. African Rickettsiosis is an endemic disease in Africa [
]. Other biological tests frequently show lymphopenia, thrombocytopenia and hepatic cytolysis (mainly an increase in alanine aminotransferase). The treatment of African Rickettsiosis consists of Doxycycline, 200 mg daily for 7 days. However, in most cases, the spontaneous prognosis (without antibiotic therapy) is favorable [
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