CASE PRESENTATION: The 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. [ncbi.nlm.nih.gov]

• Difficulty Walking

  Symptoms may include general weakness, difficulty walking, ascending paralysis, and bulbar paralysis with diplopia, culminating in respiratory failure. In Europe, toxin-mediated paralysis has rarely been noted. [ncbi.nlm.nih.gov]

• Diplopia

  Symptoms may include general weakness, difficulty walking, ascending paralysis, and bulbar paralysis with diplopia, culminating in respiratory failure. In Europe, toxin-mediated paralysis has rarely been noted. [ncbi.nlm.nih.gov]

• Tinnitus

  A 52-year-old man developed fever, headache, tinnitus, and painful joints. He reported a tick bite contracted during a summer holiday in the Netherlands, followed by erythema on his left arm three weeks earlier. [ncbi.nlm.nih.gov]

• Alopecia

  We report a case of nonscarring alopecia in a 21-year-old male who reported a recent history of tick bite to the scalp. [ncbi.nlm.nih.gov]

• Indurated Skin Lesion

  A 58-year old housewife consulted us about 1 cm sized, dark-brownish, bean-like mass which was dropped spontaneously from indurated skin lesion on her abdomen. The mass was identified morphologically as an engorged female Ixodes nipponensis. [ncbi.nlm.nih.gov]

• Annular Skin Lesion

  Abstract In May 1998, the Oregon Health Division received a report from a local physician that nine persons developed annular skin lesions accompanied by influenza-like symptoms within 8 days of leaving southern Africa. [ncbi.nlm.nih.gov]

• Arthralgia

  Rickettsial infection (tick typhus) presents as fever, lethargy, anorexia, arthralgia, generalised rash and a plaque with eschar at the original tick bite site. [aci.health.nsw.gov.au]

• Facial Pain

  Three patients developed radiating pain, paresthaesia and/or motor weakness of extremities, 2 had hemi-facial pain and paresthaesia, and 1 developed unilateral sensorineural hearing loss. [ncbi.nlm.nih.gov]

• Multiple Ulcerations

  The dominant clinical feature of his illness was the presence of multiple, ulcerated lesions (tache noires). [ncbi.nlm.nih.gov]

• Lymphocytic Infiltrate

  A biopsy specimen of an eschar had wedge-shaped tissue necrosis, hemorrhage, necrotizing vasculitis of the small venules and arterioles, and a dense perivascular lymphocytic infiltrate in the dermis. [ncbi.nlm.nih.gov]

The patient recovered without any sequelae after 7 days treatment with doxycycline. [ncbi.nlm.nih.gov]

The mechanism for hair loss is poorly understood, but the prognosis for hair regrowth appears to be favorable. [ncbi.nlm.nih.gov]

Prognosis If no infectious organisms have been transmitted by the tick, you should recover from symptoms within a day or two. The outlook for specific tick-borne illnesses varies. [drugs.com]

Although the etiology of intermediate cell histiocytosis is not well understood, this case raises the possibility that such infiltrates may represent an inflammatory reaction in some patients. [ncbi.nlm.nih.gov]

CONCLUSIONS: This report further highlights the epidemiological and clinical features of African tick bite fever. [ncbi.nlm.nih.gov]

People who download The Tick App are also invited to participate in an epidemiological study describing things like where they live and what they do so researchers can get a sense of their risk factors for tickborne illnesses. [self.com]

For more information on ticks and preventing tick bites, visit: U.S. [herald-union.com]

These results show that there is still a lot of potential for prevention through consistent symptom control. [zhaw.ch]

Author information 1 Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina. 2 Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia. 3 ViiV Healthcare, Research Triangle Park, North [ncbi.nlm.nih.gov]

References Preventing tick bites. Atlanta: Centers for Disease Control and Prevention; 16 May 2018 [accessed 2 Jul 2018]. Tick removal and testing. Atlanta: Centers for Disease Control and Prevention; 21 May 2018 [accessed Jul 2 2018]. [poison.org]