Background: Mediterranean Spotted Fever (MSF) is characterized by maculopapular rash, fever and eschar at the tick bite site. It is a summer illness caused by Rickettsia conorii that is endemic in the Mediterranean basin. The main known vector is Rhipicephalus sanguineus. Although the majority of cases are benign, complications and mortality can occur. The objectives of this study are to clinically characterize and to delineate predictors of bad outcome in patients hospitalized with Mediterranean Spotted Fever during 23 years.
Material/methods: We performed a retrospective cross-sectional study of adult patients hospitalized in an Infectious Diseases Unit between 1992 and 2014. The MSF was defined as positive R. conorii serology, positive R. conorii Polymerase Chain Reaction or clinical diagnosis (typical rash and eschar). The patients were identified by our hospital database (ICD9 082.1) and afterwards clinical records were consulted. The primary outcome of this study was patient outcome (heal or death) and secondary outcomes were Intensive/Intermediate Care Unit (ICU) admission, complications (consciousness impairment, pneumonitis, renal failure, meningitis and gastrointestinal bleeding) and predictors of death. We used the most appropriate measure of central …show more content…
The majority were women (63,7%) and the median age was 61 (interquartile range 21). The median number of cases per year was 4 (interquartile range 4). Seventy-two cases were reported in summer, 14 in autumn and 5 in spring. The majority (79%) had contact with the countryside and 64% with dogs. The most commonly reported symptoms were fever (99%), rash (96%), myalgia (88%) and headache (85%). The most frequent analytical abnormalities at admission were thrombocytopenia (77%), elevated lactate dehydrogenase 62%), hyponatremia (60%), elevated creatine phosphokinase (36%) and leucocytosis