Tick bite fever death reported in Klerksdorp, South Africa


by NewsDesk Laugh

South Africa’s National Institute of Communicable Diseases (NICD) reports the death of a 43-year-old man in Klerksdorp, North West Province from tick bite fever.

The The case schedule is as follows:

Photo/Robert Herrmann

On 19 October 2022, a 43-year-old man, with no known comorbidities, visited his local GP with flu-like symptoms including fever and sweating. On the date, he reports that he worked as a farmer and helped put out a field fire two weeks earlier. No significant travel or exposure was also reported
History in the weeks leading up to its initial showing.

It is noteworthy that the patient mentioned his fear of tick bite fever and, therefore, anti-rickettsial antibody test and baseline blood sampling were performed. According to his GP, no urethra was found on examination. The patient was then prescribed antibiotics and discharged home awaiting outstanding blood results.

A few days later on October 21, 2022, the patient’s condition deteriorated. He was admitted to Friborg Private Hospital and another class of antibiotics was prescribed as well as additional examinations. At this time, the initial results for antibodies to both brucellosis and rickets were negative, while the new results showed severe liver dysfunction (ALP = 269, GGT = 338, ALT = 299, AST = 207), a positive and negative viral plaque. Check for hepatitis. This deteriorating picture, together with a syncope and abnormal blood results, led to the patient being referred to Klerksdorp-Chipung Third Hospital (KTTH).

The patient was admitted to KTTH and was seen by a cardiologist, who soon referred the patient to a doctor. By this time, the patient’s condition was reported to be severe, and upon examination, the physician noted two types of lesions in the groin area. Testing for Rickettsia was repeated, but the samples were misplaced, so these additional tests were not performed. During his admission to the hospital, the patient suffered from epileptic status, but due to the deterioration of his condition, the examination was not performed. In the meantime, he began taking high doses of doxycycline and steroids, among other things, but unfortunately passed away on October 26, 2022 due to septicemia and multi-organ failure with heat shock.

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A blood sample was sent to the NICD lab for several tests, and a PCR test for rickettsial disease turned up positive in both serum and plasma samples, confirming that the patient had indeed died from tick-bite fever.

Tick-bite fever, otherwise known as rickettsial disease, is a bacterial infection transmitted by ticks. In South Africa, there are two types of tick-bite fever, Mediterranean spotted fever (MSF), caused by dog ​​ticks, and African tick-bite fever (ATBF) caused by amplioma or ‘bonnet’ ticks, with the latter being the most common. Being associated with rural farming and outdoor activities in the bush.

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