A case report of Rickettsia-like infection in a human patient from Slovakia

Herein we report a case of a 29-year-old man, suffering from a disease of unknown etiology and indicated a history of a bite by the unknown flying insect to both ear lobes in his anamnesis. The patient developed several nonspecific symptoms, such as fever, tension headache, and bilateral swelling of cervical lymph nodes (lymphadenitis). Moreover, he described perspiration, shivering, chills, epistaxis, several collapses, myalgia, and bone pains. Successive medical examinations of the patient confirmed several diagnoses. In addition, a blood sample was examined for the presence of tick-borne pathogens. PCR assay targeting gltA gene fragment of Rickettsia spp. brought a positive result. DNA of Rickettsia–like organism was confirmed by PCR and further sequencing. The rickettsial infection was successfully treated with doxycycline with a significant improvement of his health. This study brings a report of the molecular evidence of Rickettsia-like infection in a human patient from Slovakia, who suffered from several health problems accompanied by nonspecific febrile clinical symptoms. Although the patient did not report the tick bite before the development of clinical symptoms, he reported that he was bitten by an unknown flying insect. Thus, the possibility of rickettsial infection should be considered in similar nonspecific febrile illnesses when the bite of a flying insect is reported in personal anamnesis.