Vector-Borne Zoonotic Lymphadenitis – the Causative Agents, Epidemiology, Diagnostic Approach and Therapeutic Possibilities – An Overview

Abstract

Besides common skin pathogens, acute focal lymphadenitis in humans can be caused by a zoonotic pathogen in rare cases. Furthermore, it can develop in absence of any direct or indirect contact with infected animal in cases when the microorganism is transmitted by vector. This clinical entity is rare, and therefore not easily recognized in most regions, yet many zoonotic illnesses are considered emerging or re-emerging nowadays. Focal zoonotic vector-borne lymphadenitis and its numerous causative agents with their variegated clinical manifestations have been described in some case reports and small case series. Therefore, we tried to summarize those data in this narrative overview, with the aim to rise clinical awareness, which could improve clinical outcomes. This overview briefly covers reported pathogens, their vectors and geographic distribution, as well as their main clinical manifestations, diagnostic possibilities and recommended therapy. Vector-borne tularemia, plague, bartonellosis, rickettsioses, borreliosis and Malayan filariasis are mentioned. According to the existing data, when acute focal bacterial vector-borne zoonotic lymphadenitis is suspected, in severe or complicated cases it seems prudent to apply combined aminoglycoside (or quinolone) plus doxycycline as an empirical therapy, pending definite diagnostic results. In this field the „one health approach” and further epidemiological and clinical studies are needed.