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Volume 14, Number 5—May 2008


Rickettsia slovaca in Dermacentor marginatus and Tick-borne Lymphadenopathy, Tuscany, Italy

Marco Selmi*Comments to Author , Luigi Bertolotti†, Laura Tomassone†, and Alessandro Mannelli†1
Author affiliations: *Osservatorio Permanente per Patologie a Trasmissione Vettoriale, Lucca, Italy; †Università degli Studi di Torino, Grugliasco, Italy;

Main Article

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.

Main Article

1Current affiliation: European Food Safety Authority, Parma, Italy