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Vol. 21 - Num. 82

Clinical Reviews

Lymphadenopathy by tick bite: concerning two cases

Samsara López Hernándeza, Marta Esther Vázquez Fernándezb, Sonsoles Garcinuño Pérezc, Elena Pérez Fernándezd

aMIR-Medicina Familiar y Comunitaria. CS Arturo Eyries. Área Valladolid Oeste. Hospital Universitario Río Hortega. Valladollid. España.
bPediatra. CS Arturo Eyries. Facultad de Medicina. Universidad de Valladolid. Valladolid. España.
cServicio de Microbiología y Parasitología. Hospital Universitario Río Hortega. Valladolid. España.
dServicio de Pediatría. Hospital Universitario Río Hortega. Valladolid. España.

Correspondence: ME Vázquez. E-mail:

Reference of this article: López Hernández S, Vázquez Fernández ME, Garcinuño Pérez S, Pérez Fernández E. Lymphadenopathy by tick bite: concerning two cases. Rev Pediatr Aten Primaria. 2019;21:181-6.

Published in Internet: 19-06-2019 - Visits: 19426


Many children manifest lymphadenopathy at some point in their childhood, mainly due to infectious diseases. A correct clinical history, physical examination and complementary tests are required to allow differential diagnosis. We describe the cases of two children who presented a similar clinical presentation of regional lymphadenopathies without fever or rash. Both had as antecedent the tick bite on the scalp. The clinical presentation and the positive serology to Rickettsias led us to the diagnosis of lymphadenopathy transmitted by ticks, TIBOLA, DEBONEL or SENLAT. The serological diagnosis in our cases is limited by the existence of cross reactions with the different species of Rickettsias in particular with R. conorii (which is the one usually detected in our environment) and even with other bacteria. The evolution of both cases was favorable with treatment of azithromycin for five days. Despite the difficulty involved in the interpretation of serological results, the diagnosis of this rickettsiosis can be made in the light of clinical and epidemiological data. It should be considered the simultaneous use of other techniques to increase diagnostic sensitivity, such as PCR techniques in skin biopsy that will give us the etiological diagnosis of the infection.


Lymphadenopathy Rickettsias TIBOLA Tick bites



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