African tick bite fever - papulovesicular exanthem with fever after staying in South Africa

In the wake of expanding international tourism, rickettsioses are increasingly observed also in central Europe. African tick bite fever is a recently described, acute febrile illness with characteristic skin lesions. It is caused by Rickettsia africae, which is transmitted to humans by ticks of the Amblyomma genus. A 60-year-old woman presented with a papulovesic-ular exanthem, fever, and headache after returning from South Africa. A purple nodule with central necrosis ("tache noire"or "inoculation eschar") was noticed on the lower leg. Antibodies against rickettsia of the spotted fever group were detected serologically. Oral doxycycline led to clearance of the disease after few days of treatment.