1- Área Departamental Pediatria Médica, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa
2- Centro de Estudos de Vectores e Doenças Infecciosas, Instituto Nacional de Saúde Dr Ricardo Jorge, Setúbal, Portugal
- Brissos J, et al. BMJ Case Rep 2015. doi:10.1136/bcr-2014-207029 (Publicação integral)
Resumo: The most common transmission route of tick-borne Rickettsia is through the tick bite; nevertheless, other transmission routes should be considered. Here, we report one case of Rickettsial infection in a 15 year-old boy caused by accidental contamination of the conjunctiva through the infected fluid of a crushed engorged tick removed from a dog. Right eye pain, conjunctival hyperemia with mucopurulent exudate, chemosis and eyelid edema were the first signs and symptoms. Two days after, started with fever, myalgia, headache, abdominal pain and vomiting; physical examination showed multiple cervical adenopathies but no rash. The patient was treated with doxycycline (200 mg/d) for 7 days with progressive resolution of clinical signs. Rickettsial infection was confirmed by immunofluoresce assay with serological seroconversion in two consecutive samples. R. conorii or R. massiliae were the possible causal agents since they are the Rickettsia species found in the Rhipicephalus sanguineus dog tick in Portugal.
Palavras Chave: Conjunctival transmission, Rhipicephalus sanguineus, Rickettsia conorii, Mediterranean spotted fever, Portugal.