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Coronary involvement in Mediterranean spotted fever

Antonio Cascio1, Maria Cristina Maggio, Francesca Cardella

  • 1Dipartimento di Patologia Umana, Università di Messina, Messina, Italy. acascio@unime.it

The New Microbiologica
|December 7, 2011
PubMed

Insights

Mediterranean spotted fever (MSF), a tick-borne illness, can cause temporary coronary artery ectasia in children. This rare finding may indicate rickettsial vasculitis, requiring further research.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Mediterranean spotted fever (MSF) is an acute febrile illness caused by Rickettsia conorii, typically presenting with fever, rash, and eschar.
  • Coronary artery abnormalities are a known complication of other childhood febrile illnesses like Kawasaki disease.

Observation:

  • A 3-year-old boy with suspected MSF presented with persistent fever despite clarithromycin treatment.
  • Echocardiography revealed transient right coronary artery ectasia, prompting consideration of Kawasaki syndrome.

Findings:

  • The patient received intravenous immunoglobulin and clarithromycin, leading to fever resolution.
  • Serological tests confirmed Rickettsia conorii infection.
  • Follow-up echocardiography showed normalization of the right coronary artery within six months.

Implications:

  • Transient coronary artery ectasia may be an underrecognized manifestation of rickettsial vasculitis in MSF.
  • Further prospective studies are necessary to determine the incidence and long-term sequelae of this cardiovascular complication in MSF.

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