{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:19:31Z","timestamp":1761513571497,"version":"3.40.4"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,12,19]]},"abstract":"<jats:p>The most common transmission route of tick-borne<jats:italic>Rickettsia<\/jats:italic>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\u2005mg\/day) for 7\u2005days with progressive resolution of clinical signs. Rickettsial infection was confirmed by immunofluorescence assay with serological seroconversion in two consecutive samples.<jats:italic>Rickettsia conorii<\/jats:italic>or<jats:italic>Rickettsia massiliae<\/jats:italic>were the possible causal agents since they are the<jats:italic>Rickettsia<\/jats:italic>spp found in the<jats:italic>Rhipicephalus sanguineus<\/jats:italic>dog tick in Portugal.<\/jats:p>","DOI":"10.1136\/bcr-2014-207029","type":"journal-article","created":{"date-parts":[[2015,1,7]],"date-time":"2015-01-07T18:49:13Z","timestamp":1420656553000},"page":"bcr2014207029","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Rickettsial infection caused by accidental conjunctival inoculation"],"prefix":"10.1136","volume":"2015","author":[{"given":"Joao","family":"Brissos","sequence":"first","affiliation":[]},{"given":"Rita","family":"de Sousa","sequence":"additional","affiliation":[]},{"given":"Ana Sofia","family":"Santos","sequence":"additional","affiliation":[]},{"given":"Catarina","family":"Gouveia","sequence":"additional","affiliation":[]}],"member":"239","published-online":{"date-parts":[[2015,1,7]]},"reference":[{"key":"2025042702120877000_2015.jan07_1.bcr2014207029.1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01727425"},{"key":"2025042702120877000_2015.jan07_1.bcr2014207029.2","doi-asserted-by":"crossref","first-page":"126","DOI":"10.7150\/ijms.6.126","article-title":"Ocular manifestations of rickettsiosis: 1. 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