Mediterranean Spotted Fever: A Review of 14 Cases

We aimed to determine the followings: The patients with Mediterranean spotted fever (MSF) followed during last 10 years, the rate of these patients to the ones admitted with fever and rash, clinical features, and the factors predicting the diagnosis of MSF among the patients admitted with fever and rash. Between 1993 and 2002, all the patients admitted with fever and rash were determined. The clinical features and serological results of the patients diagnosed as MSF were further investigated through their files. The diagnosis of MSF was established by epidemiological and clinical features, and also by clinical response within 2 days after doxycycline treatment. During the last 10 years, 140 patients admitted with fever and rash, 14 (10%, 4 female, 10 male, mean age: 41 years, range: 17-70) were diagnosed as MSF. Clinical features were as follows: Fever (100%), rash (100%), myalgia and/or arthralgia (93%), headache (86%), petechiae (21%), tache noire (14%), leukocytosis (71%), thrombocytopenia (19%), and accelerated erythrocyte sedimentation rate (100%). In nine patients, the diagnosis of MSF established by epidemiological and clinical features was confirmed by serological studies. As a complication, one patient developed facial paralysis. Six patients (60%) had been given several antibiotics. MSF should be considered in the differential diagnosis when a patient is admitted with fever, maculo-papular rash, headache and/or myalgia-arthralgia especially in spring, summer and autumn