Mediterranean spotted fever and encephalitis: a case report and review of the literature

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 18; no. 1; pp. 105 - 108
• Main Authors: Duque, Vitor, Ventura, Conceição, Seixas, Diana, da Cunha, Saraiva, Meliço-Silvestre, António, Barai, Arnaldo, Mendonça, Nuno, Martins, Joana
• Format: Journal Article
• Language: English
• Published: Japan Elsevier Ltd 01-02-2012; Springer Japan
• Subjects: Anti-Bacterial Agents - therapeutic use; Antimicrobial agents; Basins; Benign; Black spot; Boutonneuse Fever - drug therapy; Boutonneuse Fever - microbiology; Boutonneuse Fever - pathology; Brain; Brain - pathology; Brain lesions; Case Report; Case reports; Doxycycline - therapeutic use; Drugs; Encephalitis; Encephalitis - drug therapy; Encephalitis - microbiology; Exanthema; Fever; Hematology, Oncology and Palliative Medicine; Hemisensory loss; Humans; Infectious Diseases; Insect Bites and Stings; Ixodidae; Literature reviews; Magnetic Resonance Imaging; Male; Medical Microbiology; Medicine; Medicine & Public Health; Mediterranean spotted fever; Middle Aged; Mortality; Neuroimaging; Rhipicephalus sanguineus; Rickettsia conorii; Thigh - pathology; Typhus; Virology; Encephalitis; Brain lesions; Hemisensory loss; Rickettsia conorii; Mediterranean spotted fever
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1007/s10156-011-0295-1

Abstract Mediterranean spotted fever (MSF) is a disease caused by Rickettsia conorii and transmitted by the brown dog tick Rhipicephalus sanguineus . It is widely distributed through southern Europe, Africa, and the Middle East. It is an emerging or a reemerging disease in some regions. Countries of the Mediterranean basin, such as Portugal, have noticed an increased incidence of MSF over the past 10 years. It was believed that MSF was a benign disease associated with a mortality rate of 1–3% before the antimicrobial drug era. It was called benign summer typhus. Severe forms were described in 1981, and the mortality rate reached 32% in Portugal in 1997. However, neurological manifestations associated with brain lesions are a rare event. We describe the case of a man with fever, maculopapular rash, a black spot, and hemisensory loss including the face on the left side of the body with brain lesions in the imaging studies.