Mediterranean spotted fever in the elderly: a prospective cohort study

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Elena Espejo1, Marta Andrés2, Maria-Consol Garcia2

  • 1Infectious Diseases Unit, Internal Medicine Service, Hospital de Terrassa (Consorci Sanitari de Terrassa), Ctra. Torrebonica s/n, 08227, Terrassa, Spain. 12088eea@comb.cat.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|April 12, 2019
PubMed

Insights

Elderly patients over 65 with Mediterranean spotted fever (MSF) experienced more severe illness but responded well to single-day doxycycline treatment, similar to younger adults.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Geriatric Medicine

Background:

  • Mediterranean spotted fever (MSF) is a tick-borne illness.
  • Understanding the impact of MSF on elderly populations is crucial for targeted healthcare.
  • Previous studies have not extensively focused on the specific characteristics and outcomes of MSF in older adults.

Purpose of the Study:

  • To compare the clinical characteristics and treatment outcomes of elderly patients (≥65 years) with Mediterranean spotted fever (MSF) against younger adults.
  • To evaluate the frequency of severe MSF and specific clinical manifestations in elderly patients.
  • To assess the efficacy and tolerability of single-day doxycycline therapy in elderly MSF patients.

Main Methods:

  • A prospective observational cohort study was conducted from 1984 to 2015.
  • Adult patients with confirmed MSF were identified and categorized into elderly (≥65 years) and younger adult groups.
  • Clinical data, including symptoms, severity, laboratory findings, and treatment response, were collected and compared between the groups.

Main Results:

  • Of 263 adult MSF cases, 53 (20.2%) were elderly.
  • Severe MSF was significantly more frequent in elderly patients (26.4% vs. 10.5%; p=0.002).
  • Elderly patients presented with more frequent gastrointestinal symptoms, impaired consciousness, lung infiltrates, edema, acute hearing loss, elevated ALT, hyponatremia, and thrombocytopenia, but less arthromyalgia. Recovery was uneventful for all patients, with similar symptom resolution times between age groups.

Conclusions:

  • Elderly patients with Mediterranean spotted fever exhibit a higher incidence of severe disease and distinct clinical manifestations compared to younger adults.
  • Single-day doxycycline therapy is an effective and well-tolerated treatment for MSF in the elderly population.
  • The findings underscore the importance of considering age-related differences in the presentation and management of MSF.
Keywords:
DoxycyclineElderlyMediterranean spotted feverRickettsia conoriiSeverityTick-borne diseases

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