tailieunhanh - Báo cáo y học: " Eschar and neck lymphadenopathy caused by Francisella tularensis after a tick bite: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Eschar and neck lymphadenopathy caused by Francisella tularensis after a tick bite: a case report. | Edouard et al. Journal of Medical Case Reports 2011 5 108 http content 5 1 108 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Eschar and neck lymphadenopathy caused by Francisella tularensis after a tick bite a case report 1 2 w -I- 3 1 1 1 Sophie Edouard Khira Gonin Yves Turc Emmanouil Angelakis Cristina Socolovschi Didier Raoult Abstract Introduction In 25 to 35 of cases the aetiological agent of scalp eschar and neck lymphadenopathy after a tick bite remains undetermined. To date Rickettsia slovaca Rickettsia raoultii and more recently Bartonella henselae have been associated with this syndrome. Case presentation A four-year-old Caucasian boy was admitted to hospital with fever vomiting and abdominal pain. On physical examination an inflammatory and suppurating eschar was seen on the scalp with multiple enlarged cervical lymph nodes on both sides. Although no tick was found in this scalp lesion a diagnosis of tick-borne lymphadenopathy was suggested and explored by serology testing and polymerase chain reaction of a biopsy from the eschar. Francisella tularensis DNA was found in the skin biopsy and the serology showed titres consistent with tularaemia. Conclusion This is to the best of our knowledge the first reported case of scalp eschar and neck lymphadenopathy after tick bite infection caused by F. tularensis. Introduction In 1997 Raoult et al. described a new tick-borne disease caused by Rickettsia slovaca in a patient presenting with a single inoculation lesion of the scalp and cervical lymphadenopathy 1 . In the same year Lakos reported 27 cases of tick-transmitted infection with similar symptoms an occipital scalp eschar and painful lymphadenopathy in the region of the tick bite. He named these infections tick-borne lymphadenopathy TIBOLA 2 . In 2002 Raoult et al. suggested that R. slovaca may be a significant cause of TIBOLA 3 . Later Oteo et al. described a similar syndrome in Spain which they named .

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