Volume 14, Number 5—May 2008
Dispatch
Rickettsia slovaca in Dermacentor marginatus and Tick-borne Lymphadenopathy, Tuscany, Italy
Marco Selmi*
, Luigi Bertolotti†, Laura Tomassone†, and Alessandro Mannelli†1
, Luigi Bertolotti†, Laura Tomassone†, and Alessandro Mannelli†1Table 1
Patients bitten by Dermacentor mariginatus and admitted to emergency units, Tuscany, Italy
| Patient no. | Year of birth | Sex | Site of tick bite | TEI* | Symptoms | Therapy 1† | Therapy 2‡ | PCR result§ | Tick-borne lymphadenopathy |
|---|---|---|---|---|---|---|---|---|---|
| 31 | 2005 | F | Head | 1 | Small nodules | No | |||
| 60 | 1937 | M | Trunk | 2 | Itching | Yes | |||
| 89 | 2003 | M | Head | 1 | No | No | Rickettsia slovaca | ||
| 117 | 1943 | F | Trunk | 3 | Wet painful rash (20 mm) over 12 mo | Yes | |||
| 121 | 1954 | F | Arm | M | None | No | |||
| 138 | 1968 | M | Head | 1 | None | No | |||
| 145 | 2001 | F | Head | 3 | Enlarged cervical lymph node, painful lymph node, fever, alopecia | 15 | R. slovaca | Yes | |
| 149 | 1939 | F | Head | 2 | Fever | 10 | R. slovaca | ||
| 154 | 1930 | M | Trunk | 1 | None | ||||
| 155 | 1968 | F | Head | 2 | Enlarged cervical lymph node, painful lymph node, fever, weariness | 15 | Yes | ||
| 159 | 1950 | M | Trunk | M | Itching | No | |||
| 175 | 2000 | M | Head | 2 | Enlarged cervical lymph node, tache noire, alopecia | 15 | Yes | ||
| 252 | 1968 | F | Head | 1 | Enlarged cervical lymph node, painful lymph node, weariness, myalgia | 15 | R. slovaca | Yes | |
| 254 | 1949 | F | Head | 3 | None | ||||
| 256 | 1949 | F | Trunk | 2 | Tache noire, itching, small nodules | 15 | R. slovaca | ||
| 263 | 2002 | F | Head | M | Fever, headache | 28¶ + 15# | |||
| 266 | 2001 | M | Head | 3 | Pain at tick bite site, enlarged, painful cervical lymph node | 21¶ + 12# | R. slovaca | Yes |
*TEI, tick engorgement index based on visual evaluation for female ticks: 1, completely unengorged; 2, intermediate (idiosoma length ≈2× scutum width); 3, engorged (idiosoma length >2× scutum width). M, male tick.
†Therapy administered (doxycycline) when patients were discharged from emergency unit.
‡Therapy administered (doxycycline) when disease was diagnosed; numbers indicate duration of treatment in days.
§Pathogen identification by outer membrane protein A gene sequencing.
¶Amoxicillin.
#Clarithromycin.
