Rickettsial Infection Caused by Accidental Conjunctival Inoculation

Brissos, J; de Sousa, R; Santos, AS; Gouveia, C

http://hdl.handle.net/10400.17/2392

Use this identifier to reference this record.

Name:	Description:	Size:	Format:
BMJ Case Rep 2015.pdf		320.75 KB	Adobe PDF	Download

Send Feedback

Authors

Abstract(s)

The most common transmission route of tick-borne Rickettsia is through tick bite; nevertheless, other transmission routes should also be considered. We report a case of rickettsial infection in a 15-year-old boy caused by accidental contamination of the conjunctiva through the infected fluid of a crushed engorged tick removed from a dog. Right eye pain, conjunctival hyperaemia with mucopurulent exudate, chemosis and eyelid oedema were the first signs and symptoms. Two days later, the boy developed fever, myalgia, headache, abdominal pain and was vomiting; physical examination showed multiple cervical adenopathies but no rash. He was treated with doxycycline (200 mg/day) for 7 days with progressive resolution of clinical signs. Rickettsial infection was confirmed by immunofluorescence assay with serological seroconversion in two consecutive samples. Rickettsia conorii or Rickettsia massiliae were the possible causal agents since they are the Rickettsia spp found in the Rhipicephalus sanguineus dog tick in Portugal.

Keywords

Accidents Animal Husbandry Anti-Bacterial Agents/therapeutic use Boutonneuse Fever/drug therapy Boutonneuse Fever/etiology Conjunctivitis, Bacterial/drug therapy Doxycycline/therapeutic use Rickettsia Animals Adolescent HDE PED