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African Tick Bite Fever — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsAfrican Tick Bite FeverSCE Infectious Diseases

A 32-year-old man presents with a 48-hour history of high fever, headache, and petechial rash. He returned from a safari in South Africa 5 days ago. Thick and thin blood films for malaria are negative. Rickettsial serology (Rickettsia africae IgM) is subsequently positive. What tick-borne rickettsiosis is most likely?

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Correct answer: C — African tick bite fever (Rickettsia africae)

African tick bite fever (ATBF) caused by Rickettsia africae is the most common rickettsial disease in travellers returning from sub-Saharan Africa, particularly after safari or bush activities. It is transmitted by Amblyomma ticks. Features include fever, headache, myalgia, regional lymphadenopathy, and often multiple eschars (inoculation sites). Unlike R. conorii, ATBF rarely causes severe disease. Treatment is Doxycycline 100 mg BD for 5–7 days.

Reference: UKHSA 2023 – Rickettsial infections; Lancet ID 2020 – Travel-associated rickettsioses