Abstract
Rickettsial infections should be considered in the presence of a maculopapular rash, especially in the endemic area with a history of tick bite. In this study, Rickettsia spp. infections of three cases will be mentioned. Three cases with positive Rickettsia spp immunofluorescent antibody serology were included in the study. Case-1 was a 17-year-old male patient, who had a history of tick bite one week before the admission was admitted with chest pain. He had tachycardia and a "tache noir" rash with a necrotic center in the area of the tick bite. Laboratory parameters showed lymphopenia, cardiac enzymes elevation. The patient’s serelogy of Rickettsia conorii IgM was 1/192 titer positive and IgG was negative. He hospitalized as acute Mediterranean Spotted Fever myocarditis. He recovered with doxycycline treatment. Case-2 was a nine-month-old girl presented with fever, rash and lymphadenomegaly on left axilla two weeks after the tick bite of her left arm. The rash was localized to the arm. R. slovaca and R. aeschlimannii serologies were detected 1/40 titer positive. After ciprofloxacin treatment her symptoms had dissapeared. Case-3 was a seven-year-old girl presented with fever reaching 39ºC for five days, myalgia and rash all over her body. She had scratched the tick from the scalp five days before the admission. Rickettsia conorii IgM serology was 1/768, IgG was 1/640 titer positive. She recovered after doxycycline treatment. Rickettsia spp. infections can lead to infections like myocarditis or the spotted fever group Rickettsiosis diseases. Complications can be prevented with early diagnosis and treatment.
Project Number
yoktur
References
- Zhang YY, Sun YQ, Chen JJ, Teng Ay, Wang T, Li PH et al. Mapping the global distribution of spotted fever group rickettsiae: a systematic review with modelling analysis. Lancet Digit Health. 2023;5:e5–15.
- Rubel F, Brugger K, Pfeffer M, Chitimia-Dobler L, Didyk YM, Leverenz S et al. Geographical distribution of Dermacentor marginatus and Dermacentor reticulatus in Europe. Ticks Tick Borne Dis. 2016;7:224-33.
- Creus BF, Cueto FB, Arenas EE, Vidal-Sanahuja RV, Munoz-Espin T, Nolla-Salas M et al. Mediterranean spotted fever: A cooperative study of 227 cases. Rev Infect Dis. 1985;7:635-42.
- Ben Mansour N, Barakett N, Hajlaoui N, Haggui A, Filali T, Dahmen R et al. Acute myocarditis complicating Mediterranean spotted fever. A case report. Ann Cardiol Angeiol (Paris). 2014;63:55-7.
- Orkun Ö, Karaer Z, Çakmak A, Nalbantoğlu S. Identification of tick-borne pathogens in ticks feeding on humans in Turkey. PLoS Negl Trop Dis. 2014;8:3067.
- Stewart AG, Stewart AGA. An update on the laboratory diagnosis of rickettsia spp. Infection. Pathogens. 2021;10:1319.
- Çelebi B, Yeşilyurt M, Kiliç S. A rickettsia case caused by Rickettsia conorii. Mikrobiyol Bul. 2018;52:431–38.
- Emiroglu M, Celebi B, Alkan G, Yilmaz Y. The first human case of Rickettsia slovaca from Turkey. Ticks Tick Borne Dis. 2021;12:101255.
- Lakos A. TIBOLA--a new tick-borne infection. Orv Hetil. 1997;138:3229-32.
- Oztoprak N, Celebi G, Aydemir H, Pişkin N, Koca R, Kuloğlu F. Mediterranean spotted fever due to contact with dog-tick. Mikrobiyol Bul. 2008;42:701-6.
Abstract
Riketsiyal infeksiyonlar özellikle endemik bölgede kene ısırması öyküsü ve makülopapüler döküntü varlığında mutlaka akla gelmelidir. Bu çalışmada Rickettsia spp. enfeksiyonu olan üç olgudan bahsedilecektir. Rickettsia spp immünfloresan antikor serolojisi pozitif tespit edilen üç olgu çalışmaya alındı. Olgu-1, bir hafta öncesinde kene ısırma öyküsü olan 17 yaşında erkek olgu göğüs ağrısı yakınması ile başvurdu. Taşikardisi ve kenenin tuttuğu alanda ortası nekrotik görünümde “tache noir” döküntüsü mevcuttu. Laboratuvar parametrelerinde lenfopeni, kardiyak enzim yüksekliği görüldü. Rickettsia conorii IgM 1/192 titrede pozitif, IgG negatifti. Olgu akut Akdeniz Benekli Ateşi enfeksiyonuna bağlı miyokardit olarak hospitalize edildi. Doksisiklin tedavisi ile iyileşme gözlendi. Olgu-2, dokuz aylık kız olgu sol kolunu kene ısırmasından iki hafta sonra ateş, vücutta döküntü ve sol koltuk altı lenfadenomegali ile başvurdu. Döküntüler kola lokalizeydi. Olgunun R. slovaca ve R. aeschlimannii serolojileri 1/40 pozitif saptandı. Siprofloksasin tedavisi ile bulguları düzeldi. Olgu-3 ise yedi yaşında kız olgu beş gündür olan 39 dereceye ulaşan ateş, myalji, tüm vücutta döküntü nedeniyle başvurdu. Anamnezinde beş gün önce saçlı deriden çocuğun kaşıyarak kene çıkardığı öğrenildi. Rickettsia conorii IgM 1/768, IgG 1/640 titrede pozitif saptandı. Doksisiklin tedavisi ile iyileşme gözlendi. Rickettsia spp. bağlı enfeksiyonlar benekli ateş grubundan miyokardite geniş spektrumda enfeksiyona yol açabilir. Erken tanı ve tedavi ile komplikasyonların önüne geçilebilinir.
Supporting Institution
yoktur
Project Number
yoktur
References
- Zhang YY, Sun YQ, Chen JJ, Teng Ay, Wang T, Li PH et al. Mapping the global distribution of spotted fever group rickettsiae: a systematic review with modelling analysis. Lancet Digit Health. 2023;5:e5–15.
- Rubel F, Brugger K, Pfeffer M, Chitimia-Dobler L, Didyk YM, Leverenz S et al. Geographical distribution of Dermacentor marginatus and Dermacentor reticulatus in Europe. Ticks Tick Borne Dis. 2016;7:224-33.
- Creus BF, Cueto FB, Arenas EE, Vidal-Sanahuja RV, Munoz-Espin T, Nolla-Salas M et al. Mediterranean spotted fever: A cooperative study of 227 cases. Rev Infect Dis. 1985;7:635-42.
- Ben Mansour N, Barakett N, Hajlaoui N, Haggui A, Filali T, Dahmen R et al. Acute myocarditis complicating Mediterranean spotted fever. A case report. Ann Cardiol Angeiol (Paris). 2014;63:55-7.
- Orkun Ö, Karaer Z, Çakmak A, Nalbantoğlu S. Identification of tick-borne pathogens in ticks feeding on humans in Turkey. PLoS Negl Trop Dis. 2014;8:3067.
- Stewart AG, Stewart AGA. An update on the laboratory diagnosis of rickettsia spp. Infection. Pathogens. 2021;10:1319.
- Çelebi B, Yeşilyurt M, Kiliç S. A rickettsia case caused by Rickettsia conorii. Mikrobiyol Bul. 2018;52:431–38.
- Emiroglu M, Celebi B, Alkan G, Yilmaz Y. The first human case of Rickettsia slovaca from Turkey. Ticks Tick Borne Dis. 2021;12:101255.
- Lakos A. TIBOLA--a new tick-borne infection. Orv Hetil. 1997;138:3229-32.
- Oztoprak N, Celebi G, Aydemir H, Pişkin N, Koca R, Kuloğlu F. Mediterranean spotted fever due to contact with dog-tick. Mikrobiyol Bul. 2008;42:701-6.
Details
| Primary Language | English |
|---|---|
| Subjects | Pediatric Infectious Diseases |
| Journal Section | Letter to the Editor |
| Authors | |
| Project Number | yoktur |
| Publication Date | December 29, 2023 |
| Acceptance Date | September 21, 2023 |
| Published in Issue | Year 2023 Volume: 48 Issue: 4 |
