Fournier Pierre-Edouard, Jensenius Mogens, Laferl Herman, Vene Sirka, Raoult Didier
Unité des Rickettsies, CNRS:UPRESA 6020, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France.
Clin Diagn Lab Immunol. 2002 Mar;9(2):324-8. doi: 10.1128/cdli.9.2.324-328.2002.
African tick-bite fever, caused by Rickettsia africae, is the most common tick-borne rickettsiosis in sub-Saharan Africa. Mediterranean spotted fever due to Rickettsia conorii also occurs in the region but is more prevalent in Mediterranean countries. Using microimmunofluorescence, we compared the development of immunoglobulin G (IgG) and IgM titers in 48 patients with African tick-bite fever and 48 patients with Mediterranean spotted fever. Doxycycline treatment within 7 days from the onset of disease significantly prevented the development of antibodies to R. africae. In patients with African tick-bite fever, the median times to seroconversion with IgG and IgM were 28 and 25 days, respectively, after the onset of symptoms. These were significantly longer by a median of 6 days for IgG and 9 days for IgM than the times for seroconversion in patients with Mediterranean spotted fever (P < 10(-2)). We recommend that sera collected 4 weeks after the onset of signs of patients with suspected African tick-bite fever should be used for the definitive serological diagnosis of R. africae infections.
由非洲立克次体引起的非洲蜱咬热，是撒哈拉以南非洲最常见的蜱传立克次体病。由康氏立克次体引起的地中海斑疹热在该地区也有发生，但在地中海国家更为普遍。我们采用微量免疫荧光法，比较了48例非洲蜱咬热患者和48例地中海斑疹热患者免疫球蛋白G（IgG）和IgM滴度的变化情况。在疾病发作后7天内使用强力霉素治疗，可显著预防针对非洲立克次体抗体的产生。在非洲蜱咬热患者中，症状出现后IgG和IgM血清转化的中位时间分别为28天和25天。这些时间比地中海斑疹热患者血清转化时间的中位数IgG长6天、IgM长9天，差异有统计学意义（P < 10⁻²）。我们建议，对于疑似非洲蜱咬热患者，应在症状出现4周后采集血清用于非洲立克次体感染的确证血清学诊断。
