Human Infection with Rickettsia sibirica mongolitimonae, Spain, 2007–2011 - Vol. 19 No. 2 - February 2013 - Emerging Infectious Disease journal - CDC

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Human Infection with Rickettsia sibirica mongolitimonae, Spain, 2007–2011 - Vol. 19 No. 2 - February 2013 - Emerging Infectious Disease journal - CDC

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Volume 19, Number 2—February 2013

Dispatch

Human Infection with Rickettsia sibirica mongolitimonae, Spain, 2007–2011

Article Contents

• The Study


• Conclusions


• Acknowledgment


• References


• Figure


• Table


• Suggested Citation

José M. Ramos , Isabel Jado, Sergio Padilla, Mar Masiá, Pedro Anda, and Félix Gutiérrez

Author affiliations: Author affiliations: Hospital General Universitario de Elche, Alicante, Spain (J.M. Ramos, S. Padilla, M. Masiá, F. Gutiérrez); Centro Nacional de Microbiología Instituto de Salud Carlos III, Madrid, Spain (I. Jado, P. Anda); Universidad Miguel Hernández, Alicante (J.M. Ramos, M. Masiá, F. Gutiérrez).

Suggested citation for this article

Abstract

Human infection with Rickettsia sibirica mongolitimonae was initially reported in 1996, and reports of a total of 18 cases have been published. We describe 6 additional cases that occurred in the Mediterranean coast region of Spain during 2007–2011. Clinicians should consider this infection in patients who have traveled to this area.

The genus Rickettsia contains ≈25 validated species of bacteria; another 25 isolates that have not been fully characterized or have not received a species designation have also been described. Signs and symptoms of human rickettsiosis caused by spotted fever group Rickettsia spp. include an inoculation eschar (a necrotic area at the site of the tick bite that might not be always present), fever, local adenopathies, and rash, although some variability can be found, depending on the infecting Rickettsia species.
R. sibirica mongolitimonae (also spelled mongolotimonae) was isolated from a Hyalomma asiaticum tick collected in the Alashian region of Inner Mongolia in 1991 (1). Designated R. mongolitimonae, the organism was identified as a member of the R. sibirica species complex (2), but further phylogenetic analyses grouped it in a cluster separate from other strains of R. sibirica.
The first human case of infection with R. sibirica mongolitimonae was reported in France in 1996 (3); since then, 18 additional cases have been described in the literature (4–14). Clinical signs and symptoms of infection are fever; a discrete, maculopapular rash; and enlarged regional lymph nodes, with or without lymphangitis. Although R. sibirica mongolitimonae infection causes a mild, not fatal, disease, complications such as acute renal failure and retinal vasculitis have been noted (7,10). We report 6 cases of human R. sibirica mongolitimonae infection from the same geographic region of Spain.