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Rickettsial meningitis

Inês Salva1, Rita de Sousa, Catarina Gouveia

  • 1Department of Pediatrics, Hospital de Dona Estefânia, Lisbon, Portugal.

BMJ Case Reports
|March 12, 2014
PubMed

Insights

Mediterranean spotted fever, a Rickettsia conorii infection, can cause rare neurological complications like meningitis. Early doxycycline treatment is crucial for favorable outcomes in suspected cases.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Public Health

Background:

  • Mediterranean spotted fever (MSF), caused by Rickettsia conorii, is prevalent in Southern Europe.
  • MSF typically presents with fever, eschar, and rash, usually mild in children.
  • Neurological complications of MSF are uncommon.

Observation:

  • An 18-year-old male presented with fever and persistent headache during summer.
  • Cerebrospinal fluid analysis showed increased cells, low glucose, and high protein.
  • Rickettsial infection was confirmed via serology.

Findings:

  • The patient was diagnosed with Rickettsia conorii meningitis.
  • Treatment with doxycycline resulted in a favorable outcome.
  • A pet squirrel and/or vectors may have been involved in transmission.

Implications:

  • This case highlights the importance of considering Rickettsial infections in meningitis differentials.
  • High clinical suspicion and early empirical doxycycline treatment are vital.
  • Understanding transmission routes, including potential zoonotic links, is crucial for prevention.

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