Tijdschrift voor Geneeskunde vol:69 issue:9 pages:456-462
Spotted fever group rickettsioses: diagnosis and treatment
Compared to viral and parasitic diseases, bacterial zoonoses, such as leptospirosis and rickettsiosis, are relatively rare causes of fever after a foreign travel. Thus, for many years, rickettsioses have been considered to be oddities in travel medicine. Nevertheless, for travelers to Sub-Saharan Africa, rickettsioses are the second most common tropical infectious disease after malaria. An infection with Rickettsia africae (“African tick bite fever” – ATBF) is the most frequent with a prevalence between 4% and 5.3% in travelers who recently visited sub-equatorial Africa. Rickettsia infections have a short incubation period causing patients to get sick while traveling. As a consequence, they mostly contact a local physician. Belgian doctors should nonetheless be aware of the patient’s condition when presenting with fever after a trip abroad.
The distinction between ATBF and “Mediterranean spotted fever” (MSF), caused by Rickettsia conorii, remains difficult due to the considerable overlap in symptoms. Although the treatment of both rickettsioses is identical, great differences exist concerning their prognosis. Particular questions during the anamnesis, an accurate clinical examination and specific technical examinations are important tools in the differential diagnosis.