Rickettsiosis is one of the most common tick-borne infections in sub-Saharan Africa.1 Mediterranean spotted fever, caused by Rickettsia conorii, is transmitted by the brown dog tick, Rhipicephalus sanguineus. African tick bite fever, caused by Rickettsia africae, is contracted from ticks of cattle and game and is transmitted via Amblyomma ticks.1 After inoculation, Rickettsiae proliferate intracellularly in the endothelium of blood vessels, and endothelial damage may cause various clinical manifestations. We herein describe 2 cases of spotted-fever group rickettsiosis after return from safari holidays in Swaziland. One patient showed unseal involvement of mucous membranes.
Büchau AS, Wurthner JU, Reifenberger J, Ruzicka T. Fever, Episcleritis, Epistaxis, and Rash After Safari Holiday in Swaziland. Arch Dermatol. 2006;142(10):1361-1375. doi:10.1001/archderm.142.10.1365