Tibola, Debonel ou Senlat, quèsaco ?

Abstract

Tick-borne lymphadenopathy (Tibola) is an emerging disease caused by rickettsial agents transmitted by Dermacentor ticks.It is also known as Senlat syndrome or Debonel.Incubation is short and mute. The characteristic clinical features is an inoculation eschar at the site of the tick bite (scalp) with cervical or occipital lympnodes which may be painful in half of the cases. It’s a benign disease whose evolution is spontaneously favorable. The most common sequelae that may occur is residual alopecia at the site of tick bite (30% of cases). A chronic asthenia can also persist for several months.The diagnosis is based upon clinical features and epidemiologic signs : after tick bite an necrotic eschar with cervical lymphadenopathy, within the cold season.The diagnosis is based of rickettsia detection on eschar biopsy by PCR before any treatment.In the absence of treatment, the evolution is favorable but the use of cyclines in adults and children over eight years is recommended. Alternatively for children under eight and pregnant women, new generation macrolides can be used. Unfortunately, even started early, treatment does not prevent sequelae such alopecia.