Rickettsiosis after tick bite: A subtle clinic picture on many occasions, we must be vigilant

Abstract

Rickettsia diseases are a group of tick-borne transmitted diseases, classified into 2 large groups: spotted fevers and typhus fevers. In addition, a new condition has been described recently, known as tick-borne lymphadenopathy.

A retrospective series is presented of paediatric cases of rickettsia diseases diagnosed in 2013 and 2014. A total of 8 patients were included, of which 2 of them were diagnosed as Mediterranean spotted fever, and 6 as tick-borne lymphadenopathy. Rickettsia slovaca, Rickettsia sibirica mongolitimonae, and Rickettsia massiliae were identified in 3 of them. Aetiology, clinical features and treatment carried out in each of them are described.

The interest of these cases is that, although most have a benign course, the high diagnostic suspicion and early treatment seem to be beneficial for its outcome.

Resumen

Las rickettsiosis constituyen un grupo de enfermedades transmitidas por la picadura de garrapatas, clasificándose en 2 grandes grupos: fiebres manchadas y fiebres tifíticas. Además, recientemente se ha descrito una nueva entidad conocida como linfadenopatía por picadura de garrapata.

Presentamos una serie retrospectiva de casos pediátricos diagnosticados de rickettsiosis durante los años 2013–2014. Se incluyeron un total de 8 pacientes, 2 de ellos diagnosticados de fiebre botonosa mediterránea y 6 de linfadenopatía por picadura de garrapata, identificándose en 3 de ellos Rickettsia slovaca, Rickettsia sibirica mongolitimonae y Rickettsia massiliae. Se describen la etiología, las características clínicas y el tratamiento realizado en cada uno de ellos.

El interés de estos casos radica en que aunque mayoritariamente presentan un curso benigno, la elevada sospecha diagnóstica y el inicio precoz del tratamiento parecen ser beneficiosos en su evolución.