First case of Mediterranean spotted fever-associated rhabdomyolysis leading to fatal acute renal failure and encephalitis

Colomba, Claudia; Imburgia, Claudia; Trizzino, Marcello; Titone, Lucina

doi:10.1016/j.ijid.2014.01.024

Cited by 13 publications

(18 citation statements)

References 11 publications

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“…Elevated protein levels were found in three cases. The glucose levels were normal in one case, slightly elevated in two, and decreased in one [1, 2, 9]. Of the four who survived, only one patient recovered without sequelae [1, 2, 9].…”

Section: Discussionmentioning

confidence: 99%

“…The glucose levels were normal in one case, slightly elevated in two, and decreased in one [1, 2, 9]. Of the four who survived, only one patient recovered without sequelae [1, 2, 9]. Although systematic pharmacokinetic studies are lacking for the concentration of doxycycline in CSF against Rickettsia conorii , a study on neuroborreliosis showed that daily doses of 200 mg of doxycycline produce a CSF concentration close to the MICs for susceptible bacteria, both in the absence and in the presence of meningeal inflammation [10].…”

Section: Discussionmentioning

confidence: 99%

“…Mediterranean spotted fever (MSF) is an emerging zoonosis caused by Rickettsia conorii , a member of the spotted fever group of rickettsiae [1]. Rhipicephalus sanguineus (dog tick) is the only recognized tick vector of rickettsiae identified in Portugal.…”

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Mediterranean Spotted Fever and Encephalitis

Almeida

Pego

Pinto

et al. 2016

Case Reports in Infectious Diseases

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Mediterranean spotted fever is a tick-borne zoonotic disease caused by Rickettsia conorii. It is transmitted by the dog tick Rhipicephalus sanguineus. It usually presents as a benign self-limited disease characterized by a skin rash, high fever, and, sometimes, a characteristic ulcer at the tick bite site called tache noir. The course of this disease is usually benign, although severe manifestations have been previously described, mainly in adults. Neurological manifestations are very unusual. We present a case of Mediterranean spotted fever with encephalitis to highlight the importance of clinical suspicion, mainly in endemic areas, the potential severity of this disease, and the need of early initiation of therapy in order to prevent severe complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Mediterranean Spotted Fever and Encephalitis

Almeida

Pego

Pinto

et al. 2016

Case Reports in Infectious Diseases

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“…In fact, atypical forms can be observed with multiorgan involvement including hepatic, renal, neurological and cardiac impairment. [1][2][3][4] We here in report a difficult diagnosis of rickettsiosis occuring after hemorrhagic fever. We also describe EN-FACE-OCT rickettsiosis retinal findings and emphasize the importance of ocular examination in atypical forms of rickettsiosis.…”

Section: Introductionmentioning

confidence: 88%

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2018

OAJTMR

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Mediterranean spotted fever can affect multiple organs but ocular involvement has not been frequently described. We report a case of a 42-year-old man who was hospitalized in emergency department for hemorrhagic fever. Laboratory tests showed a severe thrombocytopenia and disseminated intravascular coagulation. Few days later, he complained about bilateral blurred vision. Ocular examination found bilateral conjonctival hemorrhage, panuveitis associated with multiple retinal lesions. EN-FACE-OCT was performed. Rickettsia was confirmed by serological test. To our knowledge, this is the first description of OCT en face inflammation lesions associated with severe form of rickettsiosis.

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“…23 Multiple organ failure as onset of Mediterranean spotted fever days after symptoms' onset. [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Other techniques, as isolation of bacteria and/or molecular polymerase chain reaction (PCR) to genome identification, which can be performed on blood, skin biopsies and ticks, are not routinely used because of their complexity and costs. Therefore, in clinical practice, they are reserved only in cases of extremely high clinical suspicion with all the other tests proving negative.…”

Section: Methods Of Researchmentioning

confidence: 99%

Multiple organ failure as onset of Mediterranean spotted fever: a review based on a case

et al. 2016

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Mediterranean spotted fever (MSF) is an infectious disease endemic in the southern regions of Italy, with an incidence of about 400 cases/year. The bacteria responsible of the disease is Rickettsia conorii, transmitted to humans by Rhipicephalus sanguineus, the common dog tick. The infection usually manifests with a characteristic symptomatologic triad: fever, exanthema and the so called tache noire, which is the typical eschar at the site of the tick bite. Immunoglobulin M (IgM) and IgG enzymelinked immunosorbent assay and the gold standard micro-immunofluorescent assay, allow serological diagnosis. We report the case of a man suffering from MSF, whose atypical presentation and false-negative diagnostic tests delayed consistently diagnosis and therapy. Afterwards we review the literature about this topic. Contributions: PM and AS studied the case, reviewed literature and wrote the paper; AB, TC and GP studied the case; AD'A and CC studied the case and reviewed literature; AC coordinated the study group, reviewed literature and wrote the paper.Conflict of interest: the authors declare no potential conflict of interest.

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First case of Mediterranean spotted fever-associated rhabdomyolysis leading to fatal acute renal failure and encephalitis

Cited by 13 publications

References 11 publications

A Rare Case of Mediterranean Spotted Fever and Encephalitis

A Rare Case of Mediterranean Spotted Fever and Encephalitis

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Multiple organ failure as onset of Mediterranean spotted fever: a review based on a case

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