Volume 14, Number 5—May 2008
Dispatch
Rickettsia slovaca in Dermacentor marginatus and Tick-borne Lymphadenopathy, Tuscany, Italy
Table 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.