We identified Rickettsia monacensis as a cause of acute tickborne rickettsiosis in 2 humans. Its pathogenic role was assessed by culture and detection of the organism in patients’ blood samples. This finding increases the number of recognized human rickettsial pathogens and expands the known geographic distribution of Mediterranean spotted fever–like cases.
This paper describes the epidemiological and clinical features of a tick-borne disease differing somewhat from other tick-borne diseases found previously in Spain. All patients were bitten by Dermacentor marginatus or a large tick. The clinical features include a crustaceous or necrotic lesion at the site of the tick's attachment, surrounded by an erythema (erythema migrans-like) and painful regional lymphadenopathies. The probable aetiological agent is Rickettsia slovaca. Similar cases have been reported in other European countries.
This study describes the epidemiological, clinical, and microbiological characteristics of a new tick-borne disease in SpainDermacentor-borne necrosis erythema lymphadenopathy (DEBONEL). The clinical presentations include an eschar at the site of the tick bite, surrounded by an erythema and painful regional lymphadenopathy. The disease appears during the colder months and its vector is Dermacentor marginatus (D. marginatus). From January 1990 to December 2004, 54 patients presented at Hospital of La Rioja with these clinical and epidemiological data. The ratio of females to males was 32/22. The average age was 37 years. In all cases tick bites were located on the upper body (90% on the scalp). The median incubation period was 4.7 days. Signs and symptoms were mild in all cases. Only a small number of patients presented mild and nonspecific abnormalities in a complete blood cell count and mild elevation of erythrocyte sedimentation rates and C-protein reactive and liver enzyme levels. Serological evidence of acute rickettsiosis was observed in 19 patients (61%). In 29% sera tested by polymerase chain reactions (PCRs) were positive. The sequence obtained from a PCR product revealed 98% identity with Rickettsia sp. strains RpA4, DnS14, and DnS28. All ticks removed from patients were PCR-positive. Sequencing showed 8 of them identified as R. slovaca and 2 as Rickettsia sp. strains RpA4, DnS14, and DnS28.
The first cluster of cases of human Rickettsia felis infection in Spain diagnosed by PCR is reported. CASE REPORTIn September 2005, a 26-year-old woman with fever (38°C) and skin lesions and her 30-year-old husband were evaluated in our hospital. She felt unwell and began with itching skin lesions, mainly located on flexion areas of the lower extremities. On examination, she had fever, malaise, arthralgia, and pruritic papular rash over the lower extremities, abdomen, and chest. He showed the same clinical picture, although fever was absent. No other symptoms or signs were observed. Both patients and their dog had visited a forest area on the northwest of La Rioja (known as "Alto de Piqueras") 2 days previously. The dog was afebrile but symptomatic (fatigue, vomiting, and diarrhea). Multiple red points identified as chiggers (larvae of trombiculid mites, Neotrombicula autumnalis) were observed over the dog. At that time, neither ticks nor fleas were found. Nevertheless, fleas had parasitized the dog, and both patients said they had been bitten by fleas. No exposure to cats was mentioned. According to our previous experience, a presumptive diagnosis of human trombiculiasis was made. Over the last 5 years, we have diagnosed seasonal outbreaks of this disease in people who have visited the putative forest area in autumn and have presented with this itching rash (6). Nevertheless, a prospective protocol for vector-borne diseases, which included the main tick and flea-borne infections endemic in Spain (Lyme borreliosis, Bartonella infections, human anaplasmosis, Q fever and spotted fever group [SFG], and typhus group [TG] rickettsioses), was followed.Laboratory investigations showed slightly elevated liver enzymes. The values for the female patient were as follows: aspartate amino transferase, 50 IU/liter; alanine amino transferase, 45 IU/liter; and lactate dehydrogenase, 456 IU/liter. C-reactive protein was elevated (15 mg/liter; normal, Ͻ10), and the remaining biochemical values were normal. The values for the male patient were as follows: aspartate amino transferase, 39 IU/liter; alanine amino transferase, 42 IU/liter; gamma-glutamyl-transpeptidase, 79 IU/liter; and lactate dehydrogenase, 498 IU/liter. The numbers of leukocytes, platelets, and erythrocytes were normal for both patients.Serologic testing for Lyme borreliosis, cat-scratch disease, human anaplasmosis, and Q fever, as well as SFG and TG rickettsioses (immunoglobulin G [IgG] enzyme-linked immunosorbent assays and Western blotting for Lyme borreliosis and IgG indirect immunofluorescence assays for the remaining ones) were negative for both patients. DNA was extracted from the human acute blood-EDTA and serum specimens and also from a dog serum sample (all before antibiotic therapy) by using a blood DNA spin kit (Genomed; Genycell Biotech España, S.L., Granada, Spain) according to the manufacturer's instructions. These extracts were used as templates in PCRs to investigate the arthropod-borne diseases above indicated (Table 1). Due to the low sensitivity...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.