(DEBONEL = DErmacentor-BOrne Necrosis Erythema Lymphadenopathy)

Acronym for TIck-BOrne LymphAdenopathy.

Rickettsial infection (R Slovaca or R Raoultii) transmitted by a dermacentor tick.

The tick lives on vegetation in the forests, pastures and grasslands and bites preferably in hairy areas (scalp).

It is a seasonal disease during cold seasons (autumn, winter, early spring) that, after an incubation of 6-7 days, typically combines :

-        an eschar of inoculation surrounded by an erythematosus halo (which can lead to a scarring alopecia area)

-        painful homolateral cervical lymph nodes

-        fever.

A skin rash with or without edema may be associated that looks like a bacterial superinfection.

Treatment: doxycycline or macrolides for at least 7 days.

Anesthetic implications:

nothing specific

References:

-         Gaston J, Durox H, Sparsa A, Bonnnetblanc J-M, Doffoel-Hantz V. 
Dermohypodermite de la face révélatrice d’un syndrome TIBOLA. 
Arch Pédiatr 2011 ; 565-7

Updated: September 2018