A Mediterranean Spotted Fever Case in a Febrile Trombocytopenia Patient with the Presumptive Diagnosis of Crimean-Congo Haemorragic Fever

Burcu Uysal, Tulin Demir, Bekir Celebi, Bulent Acar and Selcuk Kılıc

Department of Infectious Disease, Ahi Evran University, Turkey
Department of Clinical Microbiology, Ahi Evran University, Turkey
Public Health Institution, Microbiology Reference Laboratories, Turkey

^*Correspondance to: Tulin Demir 

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Abstract:

Background: Mediterranean Spotted Fever (MSF) is a tick-borne zoonotic infection caused by Rickettsia conorii. It is commonly transmitted to humans by dog ticks, Rhipicephalus sanguineus. The infection mainly occurs from spring to summer and characterized with fever, headache, myalgia, maculopapuler rash and an inoculation escar at the site of the tick bite. The diagnosis of the disease is difficult due to the asymptomatic clinical features and symptoms, and can lead to misdiagnosis with many disease presented with fever and rash. Laboratory findings are also nonspecific but trombocytopenia, increase in the levels of transaminases, hyponatremia was observed in majority of the cases.Case Report: In this report we report a ABA case in a 35-year-old male patient, dealt with animal husbandry in an urban province presented with arthralgia, fever, malaise, headache. Patient serum was tested for Crimean-Congo Haemorrhagic Fever (CCHF) by PCR and IFA IgM/G as the clinical features and medical history was compatible with CCHF and negative results were obtained. While patient sera was negative for Coxiella burnetti by IFA, IgM 1/96, IgG 1/160 titers was detected for R.conorii. The patient received a ten day course of doxycycline, with complete resolution of all symptoms without any complication.Conclusion: Viral diseases presented with fever and rash, allergic reactions, drug erupsions, typhoid fever, leptospirosis, erlichosis, anaplasmosis and CCHF should be considered in the differential diagnosis and MSF diagnostic testing has to be included in febrile illness with thrombocytopenia, even in the absence of an eschar or a tick bite or rash.

Keywords:

Rickettsiosis; Trombocytopenia; Tache noir; Immunflorescent antibody test

Cite the Article:

Uysal B, Demir T, Celebi B, Acar B, K?l?c S. A Mediterranean Spotted Fever Case in a Febrile Trombocytopenia Patient with the Presumptive Diagnosis of Crimean-Congo Haemorragic Fever. Ann Clin Case Rep. 2017; 2: 1421.