[Boutonneuse fever in Switzerland: apropos of a case report]

The history and clinical presentation of Mediterranean spotted fever in a 72-year-old male patient with polycythemia vera are described. The patient presented soon after arrival in Bordeaux (France) with fever, arthralgia and an erythematous maculopapular skin rash involving the palms and foot soles. The clinical course was complicated by pulmonary involvement resulting in dyspnea and hypoxemia. The patient denied tick bite but had contact with a dog. Antibiotic therapy with doxycycline resulted in rapid improvement of all clinical findings. A significant rise in antibody titer against Rickettsia conorii confirmed the diagnosis. The case is discussed in relation to other published cases in Switzerland and illustrates that this infection can be acquired outside an endemic area.