Scalp eschar and neck lymphadenopathy after tick bite (SENLAT) caused by Bartonella henselae in Korea: a case report

Abstract

Background: Tick-borne lymphadenopathy (TIBOLA) is an infectious disease, mainly caused by species from the spotted fever group rickettsiae and is characterized by enlarged lymph nodes following a tick bite. Among cases of TIBOLA, a case of scalp eschar and neck lymphadenopathy after tick bite (SENLAT) is diagnosed when an eschar is present on the scalp, accompanied by peripheral lymphadenopathy (LAP). Only a few cases of SENLAT caused by Bartonella henselae have been reported.Case presentation: A 58-year-old male sought medical advice while suffering from high fever and diarrhea. Three weeks before the visit, he had been hunting a water deer, and upon bringing the deer home discovered a tick on his scalp area. Symptoms occurred one week after hunting, and a lump was palpated on the right neck area 6 days after the onset of symptoms. Physical examination upon presentation confirmed an eschar-like lesion on the right scalp area, and cervical palpation revealed that the lymph nodes on the right side were non-painful and enlarged at 2.5 × 1.5 cm. Fine needle aspiration of the enlarged lymph nodes was performed, and results of nested PCR for the Bartonella internal transcribed spacer (ITS) confirmed B. henselae as the causative agent. Conclusion: With an isolated case of SENLAT and a confirmation of B. henselae in Korea, it is pertinent to raise awareness to physicians in other Asian countries that B. henselae could be a causative agent for SENLAT.

Epidemiological, Clinical, and Microbiological Characteristics in a Large Series of Patients Affected by Dermacentor-Borne-Necrosis-Erythema-Lymphadenopathy from a Unique Centre from Spain

“…In our series, 100% of patients were aware of being bitten by a large tick. Searching in the literature, only four cases of tick-borne diseases related to B. henselae as agent of SENLAT have been published [ 28 , 34 ]. Moreover, we have studied a large number of I. ricinus and have not found Bartonella spp.…”

“…mongolitimonae or Rickettsia massiliae ) and non- Rickettsia microorganisms, like Borrelia burgdorferi sensu lato (s.l. ), Bartonella henselae , Francisella tularensis , or Coxiella burnetii [ 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. In this manuscript we will use our original term, DEBONEL, for naming the clinical picture of our patients since all of them fulfilled the criteria shown in the Section 4 and there is no consensual name.…”

Botanical Medicines With Activity Against Stationary Phase Bartonella henselae

“…In particular, ticks are known to be polymicrobially infected with multiple pathogens, 13 including Borrelia burgdorferi, the most common etiologic agent in Lyme disease. Although the ability of ticks to serve as a competent vector for transmitting B. henselae to humans is debated, ticks have been documented to carry B. henselae 12 and case reports have linked B. henselae -related diseases to a tick attachment 14,15 . Multiple papers have documented B. henselae exposure in patients with Lyme disease and patients with co-infections may experience more severe and protracted clinical manifestations 15–18 …”

“…Although the ability of ticks to serve as a competent vector for transmitting B. henselae to humans is debated, ticks have been documented to carry B. henselae 12 and case reports have linked B. henselae-related diseases to a tick attachment. 14,15 Multiple papers have documented B. henselae exposure in patients with Lyme disease and patients with co-infections may experience more severe and protracted clinical manifestations. [15][16][17][18] Currently, there is no single treatment effective for Bartonellaassociated diseases and antibiotic recommendations differ depending on specific presentations.…”

Botanical Medicines with Activity against Stationary PhaseBartonella henselae

“…In particular, ticks are known to be polymicrobially infected with multiple pathogens [28] including Borrelia burgdorferi, the most common etiologic agent in Lyme disease. Although the ability of ticks to serve as a competent vector for transmitting B. henselae to humans is debated, ticks have been documented to carry B. henselae [12] and case reports link B. henselae -related disease following a tick attachment [29–31]. Multiple papers document B. henselae exposure in patients with Lyme disease and patients with co-infections may experience more severe and protracted clinical manifestations [31–34].…”