Rickettsioses of spotted fever group in the Altai region

• Beskhlebova O.V.
• Granitov V.M.
• Shpynov S.N.
• Dedkov V.G.
• Arsen'yeva I.V.
• Pantyukhina A.N.

Abstract

The aim is to determine clinical and laboratory characteristics of North Asian tick typhus (NATT) at the present stage with the verification of the etiological agent by the complex laboratory tests.

Material and methods. The study included 118 patients with a diagnosis NATT. Paired serum samples, blood clot, biopsy from the eschar were studied. Detection of Rickettsia of tick-borne spotted fever group was performed by polymerase chain reaction (PCR) in real time. Specific antibodies were determined in the reaction of indirect immunofluorescence (IF). Statistical data processing was carried out by means of the software Statistica 10.0.

Results. DNA of R. sibirica subsp. sibirica was detected in 30/118 patients, in 1 - DNA R. heilongjiangensis. In 45/118 patients NATT was diagnosed on the basis of clinical and epidemiological data. In 42/118 patients the markers of other tick-borne infections was found. Antibodies to R. sibirica subsp. sibirica in patients with positive PCR results was detected in titers 1:40 to 1:2560.

Conclusion. Regardless of the results of laboratory tests Siberian tick typhus was characterized by cyclic course with an acute onset, fever, symptoms of intoxication, maculopapular rash, and primary lesion, regional lymphadenitis. In peripheral blood lymphopenia dominated by moderate and accelerated ESR. There was increase of liver transaminases in the biochemical analysis of blood. It was found for the first time that tick-borne rickettsiosis can be caused by two species of Rickettsia: R. sibirica subsp. sibirica and R. heilongiangensis.

Keywords:laboratory diagnostics, rickettsiosis, North Asian tick typhus, Far Eastern tick-borne rickettsiosis, clinic

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