Mediterranean Spotted Fever: Retrospective Evaluation of 16 Cases

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 muscle-joint pain during spring, summer and autumn.