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A case of mediterranean spotted fever mimicking severe sepsis


1 Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İnternal Medicine, Istanbul, Türkiye
2 Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi, Clinical Microbiology and İnfection Diseases, Istanbul, Türkiye

Correspondence Address:
Erhan Eken,
Medeniyet University Medical Faculty Göztepe Prof. Dr. Süleyman Yalçın City Hospital Department of Internal Medicine- 34000, İstanbul
Türkiye
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-9062.355965

Mediterranean spotted fever (MSF) is a tick-borne acute endemic infectious disease caused by Rickettsia conorii. While MSF may progress asymptomatically, it may also lead to clinical pictures like severe hemorrhagic fever. In this article, we are presenting an MSF case with the signs of high fever, headache, nausea, weakness and generalized maculopapular rash. The diagnosis of the female patient who had a history of contact with a tick-infested dog was confirmed with her clinical and laboratory data. The clinical and laboratory findings of the patient who was given doxycycline by 200 mg/day for 7 days were improved in a short time. Rickettsia conorii serology by the indirect immunofluorescence assay method confirmed the diagnosis of MSF. In cases of severe sepsis accompanied by high fever and generalized maculopapular rash where the source of the infection cannot be determined in the short term, carefully questioning exposure to ticks by considering the existing geographical, seasonal and endemic environmental factors may be life-saving in terms of the early diagnosis and treatment of MSF, which may become fatal even in the absence of eschars (tache noire). The symptomatology of hemorrhagic fever associated with Rickettsia conorii may be confused with that of sepsis in clinical practice.


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