Dubourg G, Socolovschi C, Del Giudice P, Fournier P E, Raoult D
Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE; Research Unit on Infectious and Tropical Emerging Diseases) UM 63 CNRS 7278 IRD 198 INSERM U1095, Faculty of Medicine, Aix-Marseille University, Marseille, France.
Eur J Clin Microbiol Infect Dis. 2014 Aug;33(8):1449-56. doi: 10.1007/s10096-014-2090-2. Epub 2014 Mar 29.
The clinical and epidemiological features of 56 patients with scalp eschar associated with neck lymphadenopathy after a tick bite (SENLAT) syndrome were evaluated at the National French Rickettsial Center. Eschar swabs, crusts, and biopsies as well as ticks and blood samples were acquired for molecular and serological assays. SENLAT predominantly affects children (p < 0.05), followed by 40- to 70-year-olds, and it is found mostly in women (p < 0.05). The seasonal distribution has two peaks: one in the spring (55%) and one in the autumn (30%). The etiological agent was identified in 18 cases, which include Rickettsia slovaca in 13 cases with incidences of two co-infections with Rickettsia raoultii and one case caused by Rickettsia sibirica mongolitimonae. Other possible agents that were found in attached ticks were Candidatus R. rioja, Coxiella burnetii, and Borrelia burgdorferi. The tick vector was Dermacentor marginatus in almost all cases, with the exception of one case, in which Ixodes ricinus was identified as the vector. Our findings show that SENLAT is a clinical entity characterized as a local infection controlled by the immune system and is neither pathogen- nor vector-specific.
法国立立克次体病中心对56例蜱叮咬后头皮焦痂伴颈部淋巴结病（SENLAT）综合征患者的临床和流行病学特征进行了评估。采集焦痂拭子、痂皮和活检样本以及蜱和血液样本进行分子和血清学检测。SENLAT主要影响儿童（p < 0.05），其次是40至70岁人群，且多见于女性（p < 0.05）。季节分布有两个高峰：一个在春季（55%），一个在秋季（30%）。在18例病例中鉴定出病原体，其中13例为斯洛伐克立克次体，2例合并拉乌尔立克次体感染，1例由西伯利亚立克次体蒙古亚种引起。在附着的蜱中发现的其他可能病原体有罗氏立克次体候选种、伯氏考克斯体和伯氏疏螺旋体。几乎所有病例的蜱传播媒介为边缘革蜱，仅有1例病例的传播媒介为蓖麻硬蜱。我们的研究结果表明，SENLAT是一种临床实体，其特征为局部感染且受免疫系统控制，既非病原体特异性也非传播媒介特异性。
