A 58-year-old man presented with fever, headache, and myalgia after traveling to South Africa, Botswana, and Zambia. Clinical examination revealed two small purpuric lesions, which were initially misdiagnosed as cutaneous anthrax. However, further investigation through PCR analysis of a skin biopsy from one lesion confirmed the presence of Rickettsia africae DNA, leading to a diagnosis of African tick-bite fever. The patient responded well to doxycycline treatment. This case highlights the importance of considering travel history and specific diagnostic methods for accurate identification of rickettsial infections, differentiating them from other febrile illnesses with skin manifestations.
Key note: Travel history and targeted diagnostics are crucial for accurate rickettsial infection diagnosis.