Tsai Kun-Hsien, Lu Hsiu-Ying, Huang Jyh-Hsiung, Fournier Pierre-Edouard, Mediannikov Oleg, Raoult Didier, Shu Pei-Yun
Research and Diagnostic Center, Centers for Disease Control, Department of Health, Taipei, Taiwan, R.O.C.
Am J Trop Med Hyg. 2009 Nov;81(5):735-9. doi: 10.4269/ajtmh.2009.09-0101.
We report the first imported case of African tick bite fever (ATBF) in a patient from Taiwan who returned from a 10-day trip to South Africa. Diagnosis was confirmed by polymerase chain reaction (PCR) from eschar biopsies. Portions of rickettsial ompA (491 bp) and ompB (273 bp) genes were amplified and subsequent sequencing of PCR product showed its 100% identity with R. africae. Microimmunofluorescence (MIF) assay of patient's serum on Days 14 and 46 after the onset of illness revealed IgG seroconversion when tested with spotted fever group (SFG) rickettsiae antigens, including R. africae. The patient clinically improved on the third day of 14-day treatment with a combination of ciprofloxacin and minocycline. Based on the patient's travel history and chronology of clinical symptoms, we strongly suspect that the tick-biting event occurred in Kruger National Park.
我们报告了首例来自台湾的非洲蜱咬热（ATBF）输入性病例，该患者从南非进行了为期10天的旅行返回。通过对焦痂活检组织进行聚合酶链反应（PCR）确诊。扩增了立克次氏体ompA（491 bp）和ompB（273 bp）基因的部分片段，随后对PCR产物进行测序，结果显示其与非洲立克次氏体的同源性为100%。在发病后第14天和第46天对患者血清进行微量免疫荧光（MIF）检测，结果显示，当用包括非洲立克次氏体在内的斑点热群（SFG）立克次氏体抗原进行检测时，IgG出现血清转化。患者在接受环丙沙星和米诺环素联合治疗14天的第三天临床症状有所改善。根据患者的旅行史和临床症状发生的时间顺序，我们强烈怀疑蜱叮咬事件发生在克鲁格国家公园。
