Rickettsia sibirica mongolitimonae infection, Sri Lanka

Rickettsia sibirica mongolitimonae infection

  • Charlotte Cordier URMITE CNRS-IRD 198 UMR 6236, Aix Marseille University, Marseille, France
  • Pierre Tattevin Hospital Pontchaillou, Rennes, France
  • Caroline Leyer Hospital Pontchaillou, Rennes, France
  • Marine Cailleaux Hospital Pontchaillou, Rennes, France
  • Didier Raoult URMITE CNRS-IRD 198 UMR 6236, Aix Marseille University, Marseille, France
  • Emmanouil Angelakis URMITE CNRS-IRD 198 UMR 6236, Aix Marseille University, Marseille, France

Abstract

Introduction. Rickettsia sibirica mongolitimonae was recently reported as a common rickettsiosis in France. Current serological evidence suggests the presence of scrub typhus and spotted fever group rickettsiosis in Sri Lanka. We detected a human case of R. sibirica mongolitimonae in Sri Lanka.


Methodology. A skin biopsy of the eschar was tested for the presence of Rickettsia spp. using qPCR assay targeting a 109-bp fragment of a hypothetical protein and by PCR amplification and sequencing targeting the ompA gene.


Results. A 30-year-old woman who had just returned from travel to a jungle in Sri Lanka was evaluated as an outpatient for fever. Examination revealed an enlarged axillary lymph node, a maculopapular rash and an eschar at her left flank and a skin biopsy of the eschar was performed. The skin biopsy was positive for the presence of Rickettsia spp. by qPCR and PCR amplification and sequencing targeting the ompA gene revealed R. sibirica mongolitimonae. Immunofluorescence assay on an acute serum sample for spotted fever group rickettsial antigens (Rickettsia conorii conorii, R. sibirica mongolitimonae, Rickettsia felis) and typhus group rickettsiae (Rickettsia typhi) was negative. The patient was treated by oral doxycycline (200 mg/day) for one week.


Conclusions. R. sibirica mongolitimonae should be considered in the differential diagnosis of patients with suspected rickettsiosis in, or returning from, Sri Lanka.

Published
2017-09-05
How to Cite
Cordier C, Tattevin P, Leyer C, Cailleaux M, Raoult D, Angelakis E (2017) Rickettsia sibirica mongolitimonae infection, Sri Lanka. The Journal Of Infection In Developing Countries 11 (08): 668-671. https://doi.org/10.3855/jidc.8743
Section
Case Reports

Keywords

Rickettsia sibirica mongolitimonae; skin biopsy; rope-like lymphangitis-associated rickettsiosis