Volume 19, Number 2—February 2013
Dispatch
Human Infection with Rickettsia sibirica mongolitimonae, Spain, 2007–2011
José M. Ramos
, Isabel Jado, Sergio Padilla, Mar Masiá, Pedro Anda, and Félix Gutiérrez
, Isabel Jado, Sergio Padilla, Mar Masiá, Pedro Anda, and Félix Gutiérrez
Table
Epidemiologic, clinical, and microbiologic characteristics associated with 6 case-patients infected with Rickettsia sibirica mongolitimonae, Spain, 2007–2011*
| Characteristic | Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | Patient 6 |
|---|---|---|---|---|---|---|
| Patient age, y/sex | 67/F | 32/M | 33/M | 42/F | 40/F | 75/F |
| Date of illness onset | 2007 Jul | 2009 Sep | 2010 Apr | 2011 Mar | 2011 Apr | 2011 Jul |
| Type of residence | Rural | Urban | Urban | Rural | Rural | Rural |
| At-risk activity | Gardening | Working at golf courses | Walking in rural area | Walking in rural area | Excursion by horse | Walking in rural area |
| Report of tick bite |
No |
No |
No |
No |
Yes |
No |
| Duration of fever, d | 10 | 4 | 5 | 5 | 6 | 4 |
| Temperature, °C | 38.5 | 39.5 | 39.4 | 39.0 | 39.0 | 39.2 |
| Headache | Yes | Yes | Yes | Yes | Yes | Yes |
| Myalgia | Yes | Yes | Yes | Yes | Yes | Yes |
| Location of eschar | Scalp | Thigh | Leg | Shoulder | Neck | Leg |
| Location of enlarged regional lymph nodes | Retroauricular | Inguinal | Inguinal | Supraclavicular | Retroauricular | None |
| Lymphangitis | No | Yes | Yes | No | No | Yes |
| Rash |
Yes |
Yes |
No |
No |
Yes |
Yes |
| Leukocytes, × 103 cells/μL | 11.1 | 2.93 | 6.40 | 6.05 | NA | NA |
| Platelets, × 103/μL | 540 | 126 | 198 | 217 | NA | NA |
| AST, IU | 79 | 50 | 48 | NA | NA | NA |
| ALT, IU | 65 | 53 | 27 | NA | NA | NA |
| C-reactive protein, mg/dL | 101 | 44 | 46 | 15.4 | NA | NA |
| Lactate dehydrogenase, IU |
642 |
567 |
NA |
NA |
NA |
NA |
| Treatment | Doxycycline | Azithromycin | Doxycycline | Doxycycline | Doxycycline | Doxycycline |
| Complications |
Hyponatremia, lethargy |
NA |
NA |
NA |
NA |
NA |
| PCR results | ||||||
| Eschar | Positive | Positive | Positive | Positive | Positive | Positive |
| Lymph nodes | NA | Negative | Negative | NA | NA | NA |
| Whole blood |
Negative |
NA |
NA |
NA |
NA |
NA |
| IgM/IgG against R. sibirica mongolitimonae† | ||||||
| Acute-phase sample | 40/160 | <20/<40 | <20/<40 | NA | 40/160 | <20/80 |
| Convalescent-phase sample |
NA |
NA |
<20/<40 |
<20/40 |
<20/80 |
<20/80 |
| IgM/IgG against R. conorii† | ||||||
| Acute-phase sample | 40/160 | <20/<40 | <20/<40 | NA | 40/160 | <20/40 |
| Convalescent-phase sample | NA | NA | <20/<40 | <20/40 | <20/80 | <20/40 |
*NA, not available; AST, aspartate aminotransferase; ALT, alanine aminotransferase.
†Determined by using in-house microimmnunofluorescence assay.
Page created: January 22, 2013
Page updated: January 22, 2013
Page reviewed: January 22, 2013
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