title: Tick-borne lymphadenopathy (TIBOLA) acquired in Southwestern Germany.
abstract: BACKGROUND
  Tick-borne lymphadenopathy (TIBOLA) was first described in 1997 in a patient in France. The causative agent, Rickettsia slovaca, is transmitted by Dermacentor ticks.
  
  
  METHODS
  In southwestern Germany we encountered a patient with a tick bite at the dorsal scalp that resulted in an eschar and nuchal lymphadenopathy. Additionally, fever, malaise as well as elevated inflammatory markers and transaminases occurred. The characteristic clinical picture along with positive antibody testing for rickettsiae of the tick-borne spotted fever group strongly suggest the diagnosis TIBOLA.
  
  
  CONCLUSIONS
  Human rickettsioses are emerging infections. Clinicians should be aware of TIBOLA as a newly described rickettsial disease. As in our case, TIBOLA may be encountered in regions/countries where R. slovaca and Dermacentor ticks are prevalent but autochthonous acquisition was not described before.
authors.affiliation: Center for Infectious Diseases and Travel Medicine, University Hospital Freiburg, Hugstetter Strasse, Germany. siegbert.rieg@uniklinik-freiburg.de
authors.forename: Siegbert
authors.initials: S
authors.lastname: Rieg
authors.forename: Sabine
authors.initials: S
authors.lastname: Schmoldt
authors.forename: Christian
authors.initials: C
authors.lastname: Theilacker
authors.forename: Katja
authors.initials: K
authors.lastname: de With
authors.forename: Silke
authors.initials: S
authors.lastname: Wölfel
authors.forename: Winfried V
authors.initials: WV
authors.lastname: Kern
authors.forename: Gerhard
authors.initials: G
authors.lastname: Dobler
mesh_terms: D000368:Aged; D000818:Animals; D000907:Antibodies, Bacterial / Q000276:immunology; D001096:Arachnid Vectors / Q000469:parasitology*; D003870:Dermacentor / Q000469:parasitology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D012281:Rickettsia / Q000276:immunology / Q000302:isolation & purification*; D012282:Rickettsia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology
chemical_list: D000907:Antibodies, Bacterial