Molecular detection of Rickettsia helvetica in lesion and blood samples after tick bites in Serbia: two cases with One Health implications.
Pavle Banović, Dragana Mijatović, Verica Simin et al.
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Case in brief
Two cases of Rickettsia helvetica infection following tick bites were reported in Serbia. A 65-year-old woman developed pruritic erythematous lesions after being bitten by Ixodes ricinus, with R. helvetica DNA detected in lesion capillary blood but not in whole blood. An 8-year-old girl presented with a pruritic scalp lesion and lymphadenopathy after a Haemaphysalis punctata bite, with R. helvetica identified in both lesion and whole blood. Both cases resolved with doxycycline treatment.
Diagnostic / clinical pearl
Molecular testing of lesion capillary blood can be crucial for diagnosing Rickettsia helvetica, especially when serology is inconclusive.
Why it matters
These cases highlight the importance of integrated surveillance for tick-borne diseases, emphasizing the need for awareness of rickettsioses in regions where they may be underdiagnosed.