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Macrophagic activation syndrome related to an infection by Rickettsia conorii in a child
M Hsairi1, S Ben Ameur1, S Alibi1
1Hedi Chaker hospital, pediatric department, Sfax, Tunisia; Faculty of medicine, Sfax, Tunisia.
Abstract:
Since the Arab Spring, a resurgence of zoonotic diseases such as rickettsiosis, endemic in the Mediterranean basin, has been observed. It preferentially infects microvascular endothelial cells of mammalian hosts inducing vasculitis with endothelial injury. Rickettsioses are considered benign infectious diseases. Severe systemic manifestations have been reported and are often explained by a delay in diagnosis. We present a case of hemophagocytic syndrome occurring in a 4-year-old Libyan girl as a complication of Mediterranean spotted fever. Rickettsial infection was confirmed by serology and the patient was treated with clarithromycin, with a favorable outcome.
Insights
Mediterranean spotted fever, a zoonotic disease, can cause severe complications like hemophagocytic syndrome. Early diagnosis and treatment with antibiotics like clarithromycin are crucial for a favorable outcome in children.
Area of Science:
- Infectious Diseases
- Pediatrics
- Hematology
Background:
- Zoonotic diseases, including rickettsiosis endemic to the Mediterranean basin, have resurged post-Arab Spring.
- Rickettsioses typically infect microvascular endothelial cells, causing vasculitis and endothelial injury, and are generally considered benign.
- Delayed diagnosis of rickettsioses can lead to severe systemic manifestations.
Observation:
- A case of hemophagocytic syndrome (HPS) is presented in a 4-year-old Libyan girl.
- The HPS occurred as a complication of Mediterranean spotted fever (MSF).
- Rickettsial infection was confirmed serologically.
Findings:
- The patient was treated with clarithromycin.
- The treatment resulted in a favorable clinical outcome.
- This case highlights a rare but severe complication of MSF in a pediatric patient.
Implications:
- Highlights the potential for severe complications, such as HPS, from Mediterranean spotted fever.
- Emphasizes the importance of prompt diagnosis and appropriate antibiotic treatment (e.g., clarithromycin) for rickettsial infections in children.
- Underscores the need for increased awareness of zoonotic disease resurgence and their potential systemic impacts in endemic regions.
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