Spotless Rickettsiosis Caused by Rickettsia slovaca and Associated with Dermacentor Ticks

• Published in: Clinical infectious diseases Vol. 34; no. 10; pp. 1331 - 1336
• Main Authors: Raoult, Didier, Lakos, Andras, Fenollar, Florence, Beytout, Jean, Brouqui, Philippe, Fournier, Pierre-Edouard
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.05.2002; University of Chicago Press
• Subjects: Animals; Bacterial diseases; Biological and medical sciences; Biopsies; Dermacentor; Female; Fever; Fluorescent Antibody Technique; France - epidemiology; Human bacterial diseases; Humans; Hungary - epidemiology; Infections; Infectious diseases; Lymph nodes; Major Articles; Male; Medical sciences; Polymerase Chain Reaction; Rickettsia; Rickettsia Infections - microbiology; Rickettsia Infections - physiopathology; Rickettsial diseases; Scalp; Skin; Specimens; Tick-Borne Diseases - microbiology; Tick-Borne Diseases - physiopathology; Ticks; Tropical bacterial diseases; Hungary; France; Europe; Parasitiformes; Human; Rickettsialosis; Infection; Rickettsiales; Dermacentor; Symptomatology; Arachnida; Acari; Ixodida; Scalp; Rickettsial infection; Arthropoda; Adenopathy; Bacteriosis; Cervical ganglion; Bacteria; Rickettsieae; Invertebrata; Erythema; Rickettsia; Ixodidae; Rickettsiaceae
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/340100

The pathogenic role of Rickettsia slovaca was first demonstrated in 1997 in a patient who presented with a single inoculation lesion of the scalp and enlarged cervical lymph nodes after receiving a bite from a Dermacentor tick. Subsequently, we evaluated the occurrence of R. slovaca infections among patients living in France and Hungary who presented with these symptoms. R. slovaca infections were confirmed by polymerase chain reaction (PCR) in 17 of 67 enrolled patients. Infections were most likely to occur in patients aged <10 years and in patients who were bitten during the colder months of the year. The median duration of incubation for the disease was 7 days. Fever was present in only 2 patients, and only 1 patient developed a rash. Sequelae included persistent asthenia (3 cases) and localized alopecia (4 cases). Immunofluorescence and/or Western blot analysis detected antibodies in 50% of tested patients. Three Dermacentor ticks obtained from patients revealed R. slovaca by PCR.