1/41. Mediterranean spotted fever in pregnancy.Mediterranean spotted fever has rarely been reported in pregnancy. We report a case occurring in a young pregnant woman, which responded well to treatment with a combination of erythromycin and rifampicin. The treatment of spotted fevers in pregnancy is discussed in detail.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/41. The first fatal case of Mediterranean spotted fever in croatia.The first lethal case of Mediterranean spotted fever in croatia is described. A previously healthy, 58-year-old man was admitted to the hospital with high fever and rash. Several days later, severe anemia, leukopenia and thrombocytopenia developed, and the patient died about eight weeks after the onset of disease. bone marrow biopsy showed hypercellularity of the cortical and trabecular bone structures with morphologically normal cells of all three hematopoietic lineages that were reduced due to regular nodular infiltrates. Serologic findings indicated that rickettsia conorii infection was the etiologic cause of the patient's death.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
3/41. Primary HIV type-1 infection misdiagnosed as Mediterranean spotted fever.The case studies of four patients, two men and two women between the ages of 42 and 54 years, are described. They presented to a hospital emergency department during the summer months with acute fever and exanthema. These are the primary symptoms of Mediterranean spotted fever (MSF), an endemic rickettsial disease in the Mediterranean basin that is seen particularly during the summer. The patients were clinically diagnosed as having MSF, but their diagnoses were not confirmed by serological testing. One patient was diagnosed with primary human immunodeficiency virus type 1 infection (hiv-1) 10 days later. The remaining three patients were diagnosed with HIV infection years later, but it is very likely that they also had primary HIV infection when MSF was presumed. When a patient develops sudden onset of fever and a maculopapular rash that is characteristic of MSF, the possibility of primary hiv-1 infection should be considered.- - - - - - - - - - ranking = 1.1666666666667keywords = fever (Clic here for more details about this article) |
4/41. Japanese spotted fever involving the central nervous system: two case reports and a literature review.Japanese spotted fever (JSF), first reported in 1984, is a rickettsial disease caused by Rickettsia japonica. Until now, affliction of the central nervous system has been rarely reported. Here we report two cases of JSF associated with a central nervous system disorder such as meningoencephalitis.- - - - - - - - - - ranking = 0.83333333333333keywords = fever (Clic here for more details about this article) |
5/41. Mediterranean spotted fever during pregnancy: case presentation and literature review.Mediterranean spotted fever (MSF) is caused by rickettsia conorii, an obligate intracellular parasite of eukaryotic cells. Although, usually this disease has a benign course, a rapidly fatal outcome can occur even in young healthy adults. We describe a case of a 40-year-old Bedouin woman gravida 11, para 10, who was admitted at 36 weeks gestation with this rickettsial disease. During pregnancy, the treatment of choice for Mediterranean spotted fever is chloramphenicol, but it seems that azithromycin could be another possible option.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
6/41. Isolation of a rickettsia related to Astrakhan fever rickettsia from a patient in chad.We isolated a novel spotted fever group rickettsia from a patient coming back from chad with fever and a maculopapulous rash. In africa, only six pathogenic spotted fever group rickettsiae have been identified, R. conorii, R. africae, R. akari, R. aeschlimannii, "R. mongolotimonae," and R. felis. Our isolate was identified by PCR amplification and sequencing of the 16S rRNA (16S rDNA), citrate synthase (gltA), and rOmpA (ompA) encoding genes. The 16S rDNA, gltA, and ompA sequences of the isolate were found to be 99.7, 99.6, and 99.5% identical with that of Astrakhan fever rickettsia, respectively. This rickettsia is endemic in the Caspian sea area and has also recently been identified in kosovo. Using mouse serotyping, the currently accepted method for the identification of spotted fever group rickettsiae, the chad isolate exhibited a specificity difference of 2 when compared to Astrakhan fever rickettsia and at least 4 when compared with other members of the R. conorii complex. The chad isolate should be considered a variant of Astrakhan fever rickettsia. This is the first description of Astrakhan fever rickettsia outside europe and the bacterium may be responsible for cases of spotted fever in chad. Although Astrakhan fever rickettsia is transmitted by rhipicephalus ticks in europe, further studies are indicated to identify its vector in africa where these ticks are also prevalent.- - - - - - - - - - ranking = 2.3333333333333keywords = fever (Clic here for more details about this article) |
7/41. Report of eight cases of fatal and severe Mediterranean spotted fever in portugal.Mediterranean spotted fever (MSF), endemically present, is associated with a low mortality and morbidity in portugal. Etiological agents are Malish and Israeli tick typhus strains of rickettsia conorii. In the last few years severe forms of MSF have emerged, with patients presenting atypical symptoms, major neurological manifestations, and multiorgan involvement, who have required intensive care facilities. Advanced age, underlying chronic disease, and delay of appropriate treatment are bad prognostic factors. In the acute phase of diagnosis, serological studies are delayed, inconclusive, and often unhelpful. A definitive diagnosis can only be made using isolation or molecular biology which can establish and clearly identify agents. Using evidence-based case reports, clinical and laboratory data were evaluated from patients with severe or fatal MSF observed in Garcia da Orta Hospital-Almada. Of the eight reference cases, four died, three in an acute fulminant stage. Of the survivors, four presented atypical involvement: ocular inoculation, massive gastric hemorrhage, acute respiratory disease (ARDS), and necrotizing vasculitis. diagnosis by isolation of the agent was made in two cases, by immunohistochemistry in three, and by the indirect fluorescent antibody test (IFA) in three others. Israeli tick typhus and Malish R. conorii strains were isolated once each in fatal cases. In early stages, diagnosis continues to be clinical and patients should start appropriate therapy without delay if clinical suspicion of rickettsiosis arises to prevent poor outcome. patients ranged in age from 39 to 71 years (mean 60), apache II ranged from 15 to 38 points and TISS 28 was between 24 and 46 points. In reported cases severity of disease was not obviously related to the usual comorbidities. Accelerated clinical course may not suggest classical MSF. Another relevant factor was prior prescription of an inappropriate antibiotic that contributed to misleading clinical features. The reported complications and atypical manifestations illustrate well the diversity of this disease.- - - - - - - - - - ranking = 0.83333333333333keywords = fever (Clic here for more details about this article) |
8/41. boutonneuse fever in a child: a case report and overview.A five and half year-old boy presented with an acute febrile illness associated with abdominal pain, generalised myalgia, arthralgia and skin rash. An elder sibling had a similar illness and had expired three days back. Initially crystalline penicillin and chloramphenicol were started. Investigations to diagnose the cause of fever viz, peripheral blood smear for malarial parasite, blood and urine cultures, Widal test and dot-ELISA for leptospirosis were negative. Weil-Felix test revealed a positive OX-2 titre of 1:100. Retrospectively, a history of close contact with dogs was elicited and a tick bite mark on the hand detected. Within five days of antibiotic therapy the fever resolved. chloramphenicol was given totally for two weeks and the child recovered fully. Rickettsial infection should be considered in a child presenting with an acute febrile illness with skin rash since the response to specific antimicrobial therapy is dramatic and life saving.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
9/41. Spotless boutonneuse fever.Mediterranean spotted fever is endemic in southern france, especially during summer. Clinical diagnosis is generally based upon the presence of a febrile eruption with or without the typical tache noire. Usual laboratory findings, which include thrombocytopenia, elevated levels of hepatic enzymes, and hyponatremia, are not specific to the disease. The diagnosis may be confirmed serologically by obtaining specific western immunoblot results and by isolation of rickettsia conorii from blood culture with use of the shell vial cell culture technique. We report here the first documented case of spotless boutonneuse fever.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
10/41. Anterior ischemic optic neuropathy associated with rickettsia conorii infection.A 43-year-old man with fever, headache, and skin rash developed unilateral acute anterior ischemic optic neuropathy. The indirect immunofluorescence test was positive for rickettsia conorii. Although retinal lesions have been described in rickettsia conorii infection, this is the first reported case of ischemic optic neuropathy. This infection should be considered in a patient with nonarteritic anterior ischemic optic neuropathy with high fever or skin rash who inhabits or travels from an endemic area.- - - - - - - - - - ranking = 0.33333333333333keywords = fever (Clic here for more details about this article) |
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