Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Mar 12;20(1):216.
doi: 10.1186/s12879-020-4940-0.

Scalp eschar and neck lymphadenopathy after tick bite (SENLAT) caused by Bartonella henselae in Korea: a case report

Jun-Won Seo  1 , Choon-Mee Kim  2 , Na Ra Yun  1 , Dong-Min Kim  3 , Sung Soon Kim  4 , Sangho Choi  4 , Hyuk Chu  4
Affiliations
Case Reports

Scalp eschar and neck lymphadenopathy after tick bite (SENLAT) caused by Bartonella henselae in Korea: a case report

Jun-Won Seo et al. BMC Infect Dis. .

Abstract

Background: Tick-borne lymphadenopathy (TIBOLA) is an infectious disease, mainly caused by species from the spotted fever group rickettsiae and is characterized by enlarged lymph nodes following a tick bite. Among cases of TIBOLA, a case of scalp eschar and neck lymphadenopathy after tick bite (SENLAT) is diagnosed when an eschar is present on the scalp, accompanied by peripheral lymphadenopathy (LAP). Only a few cases of SENLAT caused by Bartonella henselae have been reported.

Case presentation: A 58-year-old male sought medical advice while suffering from high fever and diarrhea. Three weeks before the visit, he had been hunting a water deer, and upon bringing the deer home discovered a tick on his scalp area. Symptoms occurred one week after hunting, and a lump was palpated on the right neck area 6 days after the onset of symptoms. Physical examination upon presentation confirmed an eschar-like lesion on the right scalp area, and cervical palpation revealed that the lymph nodes on the right side were non-painful and enlarged at 2.5 × 1.5 cm. Fine needle aspiration of the enlarged lymph nodes was performed, and results of nested PCR for the Bartonella internal transcribed spacer (ITS) confirmed B. henselae as the causative agent.

Conclusion: With an isolated case of SENLAT and a confirmation of B. henselae in Korea, it is pertinent to raise awareness to physicians in other Asian countries that B. henselae could be a causative agent for SENLAT.

Keywords: Bartonella henselae; Lymph nodes; Spotted fever group Rickettsiosis; Tick-borne diseases.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A photograph of the eschar on the scalp and right cervical area of a 58-year-old male patient with a confirmed diagnosis of Bartonella henselae, and a cytology report from fine needle aspiration of an enlarged cervical lymph node. a Eschar on the scalp at the first visit to the outpatient clinic. b Right cervical lymphadenopathy on the first visit to the outpatient clinic. c A photograph showing a marked reduction of size in the right cervical lymphadenopathy 10 days later
Fig. 2
Fig. 2
A phylogenetic tree based on Bartonella internal transcribed spacer (ITS) sequences from GenBank
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Im JH, Baek JH, Lee HJ, Lee JS, Chung MH, Kim M, Lee SM, Kang JS. First case of Bartonella henselae bacteremia in Korea. Infect Chemother. 2013;45(4):446–450. doi: 10.3947/ic.2013.45.4.446. - DOI - PMC - PubMed
    1. Mosbacher ME, Klotz S, Klotz J, Pinnas JL. Bartonella henselae and the potential for arthropod vector-borne transmission. Vector Borne Zoonotic Dis. 2011;11(5):471–477. doi: 10.1089/vbz.2010.0106. - DOI - PubMed
    1. Jacobs RF, Schutze GE. Bartonella henselae as a cause of prolonged fever and fever of unknown origin in children. Clin Infect Dis. 1998;26(1):80–84. doi: 10.1086/516256. - DOI - PubMed
    1. Dubourg G, Socolovschi C, Del Giudice P, Fournier PE, Raoult D. Scalp eschar and neck lymphadenopathy after tick bite: an emerging syndrome with multiple causes. Eur J Clin Microbiol Infect Dis. 2014;33(8):1449–1456. doi: 10.1007/s10096-014-2090-2. - DOI - PubMed
    1. Angelakis E, Pulcini C, Waton J, Imbert P, Socolovschi C, Edouard S, Dellamonica P, Raoult D. Scalp eschar and neck lymphadenopathy caused by Bartonella henselae after tick bite. Clin Infect Dis. 2010;50(4):549–551. doi: 10.1086/650172. - DOI - PubMed

Publication types

MeSH terms