[Hepatic anomalies in Mediterranean boutonneuse fever]

We report 3 cases of rickettsial hepatitis observed in the Lyon area which were secondary to boutonneuse fever. The temperature was elevated and clinical signs were an often painful hepatomegaly and digestive disorders. These signs are only indicative when accompanied by atypical pneumonopathy or exantherma. Indeed, if the inflammatory syndrome is clear, hepatic function is little perturbed. Diagnosis is sometimes influenced by the epidemiological situation, and depends on serologic tests and histological evidence of granulomatous hepatitis (2 of the 3 cases here). The successful antibiotic treatment shows that patients presenting febrile granulomatous hepatitis should be tested for rickettsiosis.