African tick-bite fever (ATBF) caused by Rickettsia africae is a frequent cause of fever in returned travelers. Here, we used eschar swabs and/or eschar crust samples for the molecular diagnosis of ATBF in returned travelers. In 4 of 5 patients returning from South Africa, including 3 with negative serology, R. africae was identified by molecular tools targeting 2 different genes. The findings of this study highlight the usefulness of eschar swabs and/or eschar crust samples for the diagnosis of R. africae infection.
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