A case with neurological abnormalities caused by Rickettsia raoultii in northwestern China

BMC Infectious Diseases

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[1] 0000 0001 0514 4044, grid.411680.a, School of Medicine, Shihezi University, 832002, Shihezi, Xinjiang Uygur Autonomous Region, China;Kaifeng Central Hospital, 475000, Henan, China;grid.488546.3, The First Affiliated Hospital of Shihezi University Medical College, 832002, Shihezi, China;

关键词: Rickettsia raoultii;    Neurological abnormalities;    Northwestern China;   

DOI  :  10.1186/s12879-019-4414-4

来源: publisher

【 摘 要 】

BackgroundThe number of new rickettsial species are rapidly increasing, and increasing numbers of Rickettsia raoultii (R. raoultii) infection cases have been detected in humans. However, neurological abnormalities caused by R. raoultii are rarely reported, especially in northwestern China.Case presentationA 36-year-old Kazakh shepherd with an attached tick on part temporalis, presented with right eyelid droop, lethargy, fever, headache, fever (38.0–41.0 °C) and erythematous rash. The examination of cerebrospinal fluid (CSF) showed cerebrospinal pressure of 200 mm H2O, leukocyte count of 300.0 × 106/L, adenosine deaminase of 2.15 U/L, and total protein concentration of 0.93 g/L. The diagnosis of R. raoultii infection was confirmed by six genetic markers, and semi-quantified by enzyme-linked immunosorbent assay for rickettsial antigen. The patient gradually recovered after treatment with doxycycline and ceftriaxone. R. raoultii DNA was found both in a tick detached from this patient and in 0.18% (2/1107) of blood samples collected from local shepherds.ConclusionsThis is the first reported case with neurological abnormalities caused by R. raoultii in northwestern China. It is vital to detect rickettsial agents both in blood and CSF for tick bite patients with neurological abnormalities. Public health workers and physicians should pay attention to neurological abnormalities caused by Rickettsia.

【 授权许可】

CC BY