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Cellulitis of the face associated with SENLAT caused by Rickettsia slovaca detected by qPCR on scalp eschar swab sample: An unusual case report and review of literature

Marie Hocquart 1 Hortense Drouet Paul Levet Didier Raoult 2, 1 Philippe Parola 3, 1 Carole Eldin 3, 1
1 IHU AMU - Institut Hospitalier Universitaire Méditerranée Infection
2 MEPHI - Microbes évolution phylogénie et infections
3 VITROME - Vecteurs - Infections tropicales et méditerranéennes
Abstract : Background: Tick-borne rickettsioses are infectious diseases caused by obligate intracellular Gram-negative bacteria belonging to the spotted fever groupof Rickettsia. Methods: We describe an unusual case of SENLAT (Scalp eschar and neck lymphadenopathy after tick bite), caused byRickettsia slovaca, associated with a cellulitis of the face in a 70-year-old woman, and diagnosed using qPCR on a scalp eschar swab. We review the literature regarding cases of SENLAT-associated-cellulitis and case of SENLAT diagnosed by qPCR on scalp eschar swabs. Results: We found only one previous report of SENLAT associated with a cellulitis of the face. It was a nine-year-old French girl diagnosed by seroconversion for Rickettsia sp. Our review of the literature showed that qPCR on eschar swab samples is a less invasive method than performing cutaneous biopsy of the eschar and has good sensitivity and specificity (90% and 100%, respectively). Conclusions: We report the second case of cellulitis of the face associated with the SENLAT syndrome. Detection of Rickettsia by qPCR on swab sample of the scalp eschar is a simple, noninvasive technique allowing rapid diagnosis and treatment when SENLAT is suspected.
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https://hal-amu.archives-ouvertes.fr/hal-02465936
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Submitted on : Monday, April 20, 2020 - 11:54:13 AM
Last modification on : Wednesday, October 21, 2020 - 3:13:03 AM

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Marie Hocquart, Hortense Drouet, Paul Levet, Didier Raoult, Philippe Parola, et al.. Cellulitis of the face associated with SENLAT caused by Rickettsia slovaca detected by qPCR on scalp eschar swab sample: An unusual case report and review of literature. Ticks and Tick-borne Diseases, Elsevier, 2019, 10 (5), pp.1142-1145. ⟨10.1016/j.ttbdis.2019.06.010⟩. ⟨hal-02465936⟩

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