Volume 15, Number 7—July 2009
Dispatch
Rickettsia slovaca and R. raoultii in Tick-borne Rickettsioses
Table
Characteristics of TIBOLA/DEBONEL patients with certain or probable Rickettsia slovaca infection compared with patients with certain or probable R. raoultii infection*
Characteristic | TIBOLA/DEBONEL patients, n = 86 |
||
---|---|---|---|
No. R. slovaca infections (%), n = 49†‡ | No. R. raoultii infections (%), n = 7† | p value | |
Female sex | 33/49 (67) | 7/7 (100) | 0.04 |
Mean age, y | 32 | 32 | 0.90 |
Age <12 y | 20/49 (41) | 3/7 (43) | 0.46 |
Hiking or recreational activities such as a walk in the forest | 21/28 (75) | 4/5 (80) | 0.44 |
Fever§ | 21/39 (54) | 4/5 (80) | 0.27 |
Painful eschar | 14/22 (64) | 3/3 (100) | 0.30 |
Painful adenopathies | 18/26 (69) | 5/5 (100) | 0.20 |
Face edema | 6/31 (19) | 2/5 (40) | 0.30 |
Rash | 7/30 (23) | 1/5 (20) | 0.68 |
Headache | 16/30 (53) | 4/4 (100) | 0.10 |
Alopecia | 16/27 (59) | 0/4 | 0.09 |
Asthenia | 23/33 (70) | 5/5 (100) | 0.20 |
Prolonged asthenia¶ | 10/29 (35) | 2/4 (50) | 0.46 |
Chronic asthenia# | 4/28 (14) | 1/4 (25) | 0.51 |
*Certain cases were those with positive culture, PCR, or suicide PCR results in blood or skin biopsy samples or with lymph node aspirates. Probable cases were those with identification by PCR and sequencing of the corresponding Rickettsia spp. in ticks, Western blot results demonstrating R. slovaca– or R. raoultii–specific antibodies, or a cross-absorption assay demonstrating specific antibodies against R. slovaca or R. raoultii. TIBOLA, tick-borne lymphadenopathy; DEBONEL, Dermacentor-borne necrosis erythema and lymphadenopathy.
†Denominators indicate the number of patients for whom the criterion was available.
‡Includes 14 patients previously reported (7).
§Temperature >37°5C.
¶Self-reported, persistent asthenia of 1 to 6 months.
#Self-reported persistent or relapsing asthenia of >6 consecutive months.
References
- Parola P, Vestris G, Martinez D, Brochier B, Roux V, Raoult D. Tick-borne rickettiosis in Guadeloupe, the French West Indies: isolation of Rickettsia africae from Amblyomma variegatum ticks and serosurvey in humans, cattle, and goats. Am J Trop Med Hyg. 1999;60:888–93.PubMed
- Gouriet F, Rolain JM, Raoult D. Rickettsia slovaca infection, France. Emerg Infect Dis. 2006;12:521–3.PubMed
- Estrada-Pena A, Bouattour A, Camicas JL, Walker AR. Ticks of domestic animals in the Mediterranean region. Zaragoza (Spain): University of Zaragoza; 2004.