Abstract
BackgroundScalp Eschar and Neck LymphAdenopathy after Tick bite is a zoonotic non-pathogen-specific disease most commonly due to Rickettsia slovaca and Rickettsia raoultii. Diagnosis is mostly based only on epidemiological and clinical findings, without serological or molecular corroboration.We presented a clinical case in which diagnosis was supported by entomological identification and by R. slovaca DNA amplifications from the tick vector.Case presentationA 6-year-old child presented with asthenia, scalp eschar and supraclavicular and lateral-cervical lymphadenopathy. Scalp Eschar and Neck LymphAdenopathy After Tick bite syndrome following a Dermacentor marginatus bite was diagnosed. Serological test on serum revealed an IgG titer of 1:1024 against spotted fever group rickettsiae, polymerase chain reaction assays on tick identified Rickettsia slovaca. Patient was successfully treated with doxycycline for 10 days.ConclusionsA multidisciplinary approach including epidemiological information, clinical evaluations, entomological identification and molecular investigations on tick, enabled proper diagnosis and therapy.
Highlights
Scalp Eschar and Neck LymphAdenopathy after Tick bite is a zoonotic non-pathogen-specific disease most commonly due to Rickettsia slovaca and Rickettsia raoultii
SENLAT (Scalp Eschar and Neck LymphAdenopathy after Tick bite) is a zoonotic non-pathogen-specific disease characterized by enlarged neck lymph nodes and scalp eschar after a tick bite
Cases of tick-borne lymphadenopathy have previously been reported in Tuscany (Italy) and R. slovaca-positive ticks found in wild boars (Sus scrofa) were detected in four Italian regions (Liguria, Sardinia, Tuscany and Abruzzo), pinpointing the potential eco-epidemiological role of this species as wild reservoir host [3,4,5]
Summary
A multidisciplinary approach including epidemiological information, clinical evaluations, entomological identification and molecular investigations on tick, enabled proper diagnosis and therapy.
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