Abstract
BackgroundMyocarditis and pericarditis are rare complications of rickettsiosis, usually associated with Rickettsia rickettsii and R. conorii. African tick-bite fever (ATBF) is generally considered as a benign disease and no cases of myocardial involvement due to Rickettsia africae, the agent of ATBF, have yet been described.Case presentationThe patient, that travelled in an endemic area, presented typical inoculation eschars, and a seroconversion against R. africae, was admitted for chest pains and increased cardiac enzymes in the context of an acute myocarditis.ConclusionOur findings suggest that ATBF, that usually presents a benign course, may be complicated by an acute myocarditis.
Highlights
Myocarditis and pericarditis are rare complications of rickettsiosis, usually associated with Rickettsia rickettsii and R. conorii
Rickettsia africae, the causative agent of African tick-bite fever, an emerging disease transmitted by Amblyomma ticks in rural sub-Saharan Africa, has been recently described [4]
We report the first evidence that African tick-bite fever (ATBF) may be complicated by an acute myocarditis
Summary
Myocarditis and pericarditis are rare complications of rickettsiosis, usually occuring in the setting of an acute disseminated infection due to Rickettsia rickettsii and R. conorii [1,2,3]. He developed in the following week several inguinal lymphadenitis and severe asthenia His wife presented – with a two days delay – an acute febrile illness, associated with a macular rash on both legs, myalgias, arthralgias and headache. This diagnosis was confirmed by a R. africae seroconversion of patient A (titres of 1/64 in IgG and 1/16 in IgM on the convalescent serum taken one month after the symptom onset) and by a sustained positive R. africae serology for his wife (IgG titers of 1:64 and IgM titres of 1:32 on both acute and convalescent sera; IgG titers >= 1:64 and IgM titers >= 1:32 are considered indicative of infection by R. africae). Both patients were treated with doxycycline 200 mg daily with rapid recovery
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