Related Experiment Videos
[Malignant form of Mediterranean boutonneuse fever. 6 cases]
Abstract:
Six cases of severe Mediterranean boutonneuse fever are reported. The clinical diagnosis, based on the presence of summer fever with an erythematous rash plus an escharr in three patients, was confirmed by serology (microagglutination in 1 case, indirect immunofluorescence in 4). The symptoms resembled those of Rocky Mountain spotted fever associating, as they did, a purpuric rash with neurological signs (impaired consciousness in all 6 cases, convulsion in 2), respiratory symptoms (5) and digestive signs (diarrhoea in 1 case, enlargement of the liver in 4). Laboratory examinations showed thrombopenia (6), rise in serum transaminases (5), LDH (5) and CPK (6), increased in blood urea and creatinine levels (6), hyponatraemia (6), hypokaliaemia (5) and hypocalcaemia (5). Two patients treated with doxycycline recovered and 4 died. Among these, 1 had received erythromycin, 1 a tetracycline and 1 doxycycline.
Insights
Severe Mediterranean boutonneuse fever presents with fever, rash, and eschar, mimicking Rocky Mountain spotted fever. Early doxycycline treatment improved outcomes, while other antibiotics showed limited efficacy in this severe case series.
Area of Science:
- Infectious Diseases
- Tick-borne Illnesses
- Clinical Case Studies
Background:
- Mediterranean boutonneuse fever (MBF) is a tick-borne illness caused by Rickettsia conorii.
- Severe manifestations of MBF can be life-threatening and require prompt diagnosis and treatment.
Observation:
- This study reports on six severe cases of MBF presenting with fever, erythematous rash, and eschar.
- Clinical symptoms included neurological impairment, respiratory distress, and gastrointestinal issues.
- Laboratory findings revealed significant abnormalities such as thrombocytopenia, elevated liver enzymes, and renal dysfunction.
Findings:
- Serological confirmation supported the clinical diagnosis of MBF.
- Two patients treated with doxycycline showed recovery.
- Four patients died, with varied antibiotic treatments including erythromycin and tetracycline.
Implications:
- Severe MBF poses a significant diagnostic and therapeutic challenge.
- Doxycycline appears to be an effective treatment for severe MBF.
- Further research is needed to understand the pathogenesis and optimize treatment strategies for severe MBF.