Old and new tick-borne rickettsioses

Global distribution of the aetiological agents of the various rickettsioses. Those underlined were described more than 20 years ago. 1: Rickettsia conorii subsp. conorii; 2: R. conorii subsp. israelensis; 3: R. conorii subsp. caspia; 4: R. conorii subsp. indica; 5: R. sibirica subsp. sibirica; 6: R. massiliae; 7: R. heilongjiangensis; 8: R. japonica; 9: R. parkeri; 10: R. aeschlimannii; 11: R. australis; 12: R. honei; 13: R. monacensis; 14: R. rickettsii; 15: R. slovaca; 16: R. raoultii; 17: R. sibirica subsp. mongolitimonae; 18: R. africae; 19: R. helvetica; 20: R. akari; 21: R. amblyommii.

(A) Eschar associated with lymphangitis; (B) Cutaneous eschar and eruption following tick bite. The patients gave informed consent for these photographs to be published.

Western blot before and after cross-adsorption with Rickettsia conorii (1), R. massiliae (2), Candidatus R. felis (3) and R. aeschlimanii (4). When cross-adsorption is performed with R. felis, the specific antigen-corresponding line disappears. This implicates R. felis as the causative microorganism.