Fifteen years after the initial detection of Rickettsia slovaca in ticks in Portugal, 3 autochthonous cases of R. slovaca infection were diagnosed in humans. All patients had an eschar on the scalp and lymphadenopathy; 2 patients had facial edema. R. slovaca infection was confirmed by serologic testing, culture, and PCR.
Keywords: DEBONEL; Dermacentor-borne-necrosis-erythema lymphadenopathy; Portugal; Rickettsia slovaca; TIBOLA; facial edema; lymphadenopathy; rickettsiae; rickettsial infections; scalp eschar; tick-borne lymphadenopathy; vector-borne infections.