Rickettsia, a case of TIBOLA

Rickettsia are gaining special importance following new species discovered in recent years. The most common in our environment is Rickettsia conorii infection, which produces the so-called Mediterranean fever boutonneuse. Recently are included more often in the differential diagnosis the called TIBOLA (tick-borne lymphadenopathy) or also known as DEBONEL (dermacentor-borne necrosis lymphadenopathy erythema), whose first serologic confirmation dates back to 1997 in France and is transmitted by the tick Dermacentor marginatus, produced by R. slovaca among others and has similar clinical features as the Mediterranean spotted fever.

The case of an 8 year-old who came to the Emergency Services with the presence of fever and scabby lesion, necrotic scalp and cervical lymphadenopathy of occipital and retroauricular location is presented, referring tick bite 15 days ago. The diagnosis is confirmed by clinical and serological tests conorii Rickettsia cross-presentation. After Erythromycin dose regimen of 40mg/kg/day for 8 days, progressive disappearance of lesions was evident after a month