Mediterranean Spotted Fever: Retrospective Evaluation Of 16 Cases

Abstract

Objectives: Mediterranean spotted fever (MSF) is an acute febrile, zoonotic disease caused by Rickettsia conorii and endemic infectious disease in Mediterranean countries. Patients and Methods:In this study, a retrospective examination of 16 cases (4 females, 12 males; mean age 38.9±13.0; range 18 to 64 years) that were diagnosed with rickettsioses between 1987-2007 was performed. Diagnosis of MSF was based upon epidemiological and clinical features, indirect immunofluorescence antibody (IFA), as well as response to doxycycline therapy. Results: High fever and maculopapular rash were present in all cases. Palmar and plantar rash were evident in 13 (81.3%) and eschar in eight (50%) cases. All cases responded to treatment within 2±0.9 days, and no death was observed. Conclusion: Mediterranean spotted fever should be considered in the differential diagnosis of all patients admitting with fever, maculopapular rash, headache and/or musclejoint pain during spring, summer and autumn.

Severe clinical forms of Mediterranean spotted fever: A case series from an endemic area in Bulgaria

“…Similar epidemiological data were identified by Pitigoi et al 4 , Romdhane et al 23 and Kuloglu et al 24 . The clinical symptoms and signs were similar to ones presented in other studies 4,8,13,15,20,[23][24][25][26] . The leading clinical features in severe forms were high fever with severe headache, hepatomegaly/splenomegaly and the combination of older age and underlying diseases.…”

“…Laboratory data from the presented study established liver impairment, kidney failure, marked elevation of CRP, alteration in CSF and thrombopenia. Those laboratory findings were not distinguished by other studies in Europe 4,8,19,20,25,27,28 . Severe case with neurological deterioration, renal impairement, thrombocytopenia and enlarged liver enzymes was reported by Tzavella et al 28 .…”

“…Gastrointestinal signs were not rare in the presented study. Yilmaz et al 25 observed gastrointestinal complaints in 25% and Raoult et al 19 noted diarrhea in 14% of severe cases. Acute renal failure was mentioned as a risk factor for fatal outcome 16 .…”