**10. Conclusion**

In conclusion, rickettsioses are a worldwide threat that must be suspected in travellers returning from endemic areas. Most cases are caused by tick-bites, although in some areas of the world old diseases as typhus are present, and the risk exists. Rickettsiosis must be suspected in all patients with fever, exanthema with or without rash. Starting treatment with doxycycline when possible may be essential to rapidly recover and avoid complications. ATBF along with malaria is the leading cause of fever after returning from Sub-Saharan Africa.
