Article Text

Download PDFPDF
Rickettsial infection caused by accidental conjunctival inoculation
  1. Joao Brissos1,
  2. Rita de Sousa2,
  3. Ana Sofia Santos2,
  4. Catarina Gouveia1
  1. 1Department of Pediatric, Hospital Dona Estefania, Lisboa, Portugal
  2. 2Centro de Estudos de Vectores e Doenças Infecciosas, Instituto Nacional de Saúde Dr Ricardo Jorge, Setúbal, Portugal
  1. Correspondence to Dr Joao Brissos, joao_brissos{at}


The most common transmission route of tick-borne Rickettsia is through tick bite; nevertheless, other transmission routes should also be considered. We report a case of rickettsial infection in a 15-year-old boy caused by accidental contamination of the conjunctiva through the infected fluid of a crushed engorged tick removed from a dog. Right eye pain, conjunctival hyperaemia with mucopurulent exudate, chemosis and eyelid oedema were the first signs and symptoms. Two days later, the boy developed fever, myalgia, headache, abdominal pain and was vomiting; physical examination showed multiple cervical adenopathies but no rash. He was treated with doxycycline (200 mg/day) for 7 days with progressive resolution of clinical signs. Rickettsial infection was confirmed by immunofluorescence assay with serological seroconversion in two consecutive samples. Rickettsia conorii or Rickettsia massiliae were the possible causal agents since they are the Rickettsia spp found in the Rhipicephalus sanguineus dog tick in Portugal.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.