Central European Journal of Immunology
eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
Current issue Archive Manuscripts accepted About the journal Special Issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors Publication charge
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
Share:
Send email
Share:
abstract:
Case report

Skin ulcer and maculopapular rash with inguinal lymph node enlargement: a case report of a 46-year-old female patient from north-eastern Poland with Rickettsia spp. and Francisella tularensis co-infection

Karol Borawski
1
,
Anna Lebensztejn
2
,
Piotr Czupryna
1
,
Maciej Kondrusik
1
,
Sławomir Pancewicz
1
,
Justyna Adamczuk
1
,
Tomasz Chmielewski
3
,
Anna Moniuszko-Malinowska
1

  1. Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Poland
  2. Students’ Scientific Association, Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Poland
  3. National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
Cent Eur J Immunol 2025; 50 (3)
DOI: https://doi.org/10.5114/ceji.2025.154280
Online publish date: 2025/09/22
View full text Get citation
 
PlumX metrics:
North-eastern Poland is an endemic region for tick-borne diseases, especially Lyme disease and tick-borne encephalitis. However, less common diseases such as rickettsiosis and tularemia may occur after a tick bite.

In this paper we present a rare case of Rickettsia spp. and Francisella tularensis co-infection in a 46-year-old female patient with no history of travel and no chronic diseases, confirmed by serological and molecular tests. The symptoms appeared 5-7 days after the tick bite and lasted for 2 weeks. On physical examination, a maculopapular rash over the entire body, an ulcer on the left lower extremity, and an enlarged inguinal lymph node were noted.

We concluded that rare diseases such as rickettsiosis and tularemia should be included in differential diagnosis of fever, lymphadenopathy and skin changes after a tick bite. Co-infection with Rickettsia spp. and F. tularensis is possible in patients after a tick bite. Quick diagnosis allows proper treatment (with doxycycline) and complete recovery.
keywords:

Poland, Rickettsia spp, Francisella tularensis, spotted fever, tularemia, tick, co-infection, immunoserology
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2025 Termedia Sp. z o.o.
Developed by Bentus.