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Volume 15, Number 7—July 2009

Dispatch

Rickettsia slovaca and R. raoultii in Tick-borne Rickettsioses

Philippe Parola, Clarisse Rovery, Jean Marc Rolain, Philippe Brouqui, Bernard Davoust, and Didier RaoultComments to Author 
Author affiliations: Unité des Rickettsies, Marseille, France (P. Parola, C. Rovery, J.M. Rolain, P. Brouqui, D. Raoult); Direction Régionale du Service de Santé des Armées, Toulon, France (B. Davoust)

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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.

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