Department of Environmental Sciences, Emory University, Atlanta, GA, USA.
Centro Nacional de Diagnóstico e Investigación en Endemo-epidemias, Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos C Malbrán", Buenos Aires, Argentina.
Ticks Tick Borne Dis. 2020 Jul;11(4):101436. doi: 10.1016/j.ttbdis.2020.101436. Epub 2020 Apr 23.
The aim of this work was to compare the epidemiological and clinical characteristics of Rickettsia parkeri rickettsiosis related to Amblyomma triste and Amblyomma tigrinum ecological regions in Argentina. We reviewed cases of R. parkeri rickettsiosis from 2007 to 2017 evaluated at Muñiz Hospital, directly or through referral. Univariate analysis was used to examine the association between different variables and the disease related by each vector species. The eighteen cases of R. parkeri rickettsiosis included had fever, inoculation eschar and all except one had rash. Regional differences in epidemiological variables were identified, depending on the vector. There was a significantly increased risk of exposure to A. tigrinum in peri-domestic areas (odd ratio 12, p = 0.02), whereas an increased risk of exposure to A. triste was evident in wildlife areas (odd ratio 12, p = 0.02). Seasonality of R. parkeri rickettsiosis differed based on its vector. Cases associated with A. triste occurred predominantly during spring and summer, whereas those associated with A. tigrinum occurred during fall, winter, and springtime. Exanthema was maculopapular (13/18), maculo-vesicular (3/18) or petechial (1/18). No clinical differences were identified depending on the vector.
本研究旨在比较阿根廷帕克氏立克次体病与 Amblyomma triste 和 Amblyomma tigrinum 生态区相关的流行病学和临床特征。我们回顾了 2007 年至 2017 年期间在 Muñiz 医院评估的帕克氏立克次体病病例，这些病例是直接或通过转诊而来的。我们采用单变量分析来检验不同变量与每种媒介物种相关疾病之间的关系。18 例帕克氏立克次体病患者均有发热、接种性溃疡和皮疹（除 1 例外）。根据媒介的不同，确定了流行病学变量的区域差异。在家庭周围地区接触 A. tigrinum 的风险显著增加（优势比 12，p=0.02），而在野生动物地区接触 A. triste 的风险增加（优势比 12，p=0.02）。帕克氏立克次体病的季节性也因其媒介而异。与 A. triste 相关的病例主要发生在春季和夏季，而与 A. tigrinum 相关的病例则发生在秋季、冬季和春季。出疹表现为斑丘疹（13/18）、斑疱疹（3/18）或瘀点（1/18）。根据媒介的不同，未发现临床差异。
