CONCISE AR T ICLE

In May 1999, a cluster of cases of African tick-bite fever was detected in six Italian tourists who had returned from South Africa. All of the patients had moderate fever and cutaneous eschars. Regional lymph- angitis was observed in three of the patients and skin rash in two. By comparing the number of eschars with the number of detectable bite sites it was suggested that at least two-thirds of the biting vectors were capable of transmitting Rickettsia africae. The clinical course of disease was mild in all cases, and all but one of the pa- tients recovered spontaneously before antibiotic treat- ment was initiated. The diagnosis of African tick-bite fe- ver was confirmed serologically using both microimmu- nofluorescence and Western blot tests.