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[Mediterranean boutonneuse fever disclosed by severe neurological involvement]
B Benhammou1, A Balafrej, N Mikou
1Service de Pédiatrie II, Hôpital d'Enfants, Rabat, Maroc.
Abstract:
The authors report a case of mediterranean boutonneuse fever disclosed in a 6 year-old child presenting with severe neurological disorder, coma, hypotonia, sphincteral disorders, rash and eschar at the site of bite. Rise of antibodies detected by indirect immunofluorescence test (1/80----1/320) confirmed the diagnosis. Visualization of ischemic internal capsules at cerebral CT scan brought evidence of vascular lesions in rickettsial disease.
Insights
Mediterranean boutonneuse fever, a tick-borne illness, can cause severe neurological issues in children. This case highlights vascular damage in the brain, confirmed by CT scans, emphasizing the disease
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Rickettsial Infections
Background:
- Mediterranean boutonneuse fever is a tick-borne illness caused by Rickettsia conorii.
- Neurological involvement is a known, though less common, complication.
Observation:
- A 6-year-old child presented with severe neurological symptoms including coma and hypotonia.
- The child also exhibited a rash and an eschar at the site of a tick bite.
- Sphincteral dysfunction was noted as part of the clinical presentation.
Findings:
- Antibody levels, detected via indirect immunofluorescence test, confirmed the diagnosis (1/80–1/320).
- Cerebral CT scans revealed ischemic lesions in the internal capsules.
- These findings provided evidence of vascular damage associated with the rickettsial disease.
Implications:
- This case underscores the potential for severe neurological complications, including vascular lesions, in pediatric Mediterranean boutonneuse fever.
- Early diagnosis and recognition of neurological manifestations are crucial for managing rickettsial infections.
- Cerebral CT imaging is valuable in detecting vascular complications in affected children.