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{{Infobox disease |
{{Infobox medical condition (new)
Name = Boutonneuse fever |
| name = Boutonneuse fever
Image = Eschar and spots Mediterranean spotted fever.gif|
| synonyms = '''Mediterranean spotted fever'''
Caption = Typical eschar and spots on the leg of a patient with Boutonneuse fever<ref name=rovery/>|
| image = Eschar and spots Mediterranean spotted fever.gif
| caption = Typical [[eschar]] and spots on the leg of a patient with Boutonneuse fever<ref name=rovery/>
ICD10 = {{ICD10|A|77|1|a|75}} |
ICD9 = {{ICD9|082.1}} |
| pronounce =
| field = [[Infectious disease (medical specialty)|Infectious disease]]
ICDO = |
|
OMIM = |
DiseasesDB = 31780 |
| symptoms =
MedlinePlus = |
| complications =
| onset =
eMedicineSubj = |
| duration =
eMedicineTopic = |
MeshID = D001907 |
| types =
| causes =
}}
| risks =
'''Boutonneuse fever''' (also called '''Mediterranean spotted fever''', '''fièvre boutonneuse''', or '''Marseilles fever''' or ' tick bite fever') is a [[fever]] as a result of a [[Rickettsia]] infection caused by the bacterium ''[[Rickettsia conorii]]'' and transmitted by the dog tick ''[[Rhipicephalus sanguineus]]''. Boutonneuse fever can be seen in many places around the world, although it is endemic in countries surrounding the [[Mediterranean Sea]]. This disease was first described in [[Tunisia]] in 1910 by Conor and Bruch and was named ''boutonneuse'' ([[French language|French]] for "spotty") due to its [[papular]] skin rash characteristics.<ref>{{cite journal |author=Conor, A & A Bruch
| diagnosis =
|title=Une fièvre éruptive observée en Tunisie
| differential =
|journal=Bull Soc Pathol Exot Filial |volume=8 |pages=492–496 |year=1910
| prevention =
}}</ref><ref name=rovery>{{cite journal |author=Rovery C; Brouqui P; Raoult D |title=Questions on Mediterranean Spotted Fever a Century after Its Discovery
| treatment =
|journal=Emerg Infect Dis |volume=14 |pages=1360–1367 |year=2008 |doi=10.3201/eid1409.071133 |issue=9 |pmid=18760001 |pmc=2603122
| medication =
}}</ref>
| prognosis =
| frequency =
| deaths =
}}{{More citations needed|date=January 2024}}
'''Boutonneuse fever''' (also called '''Mediterranean spotted fever''', '''''fièvre boutonneuse''''', '''Kenya tick typhus''', '''Indian tick typhus''', '''Marseilles fever''', or '''Astrakhan fever''') is a [[fever]] as a result of a [[rickettsia]]l infection caused by the bacterium ''[[Rickettsia conorii]]'' and transmitted by the dog tick ''[[Rhipicephalus sanguineus]]''. Boutonneuse fever can be seen in many places around the world, although it is endemic in countries surrounding the [[Mediterranean Sea]]. This disease was first described in [[Tunisia]] in 1910 by Conor and Bruch and was named ''boutonneuse'' ([[French language|French]] for "spotty") due to its [[papular]] skin-rash characteristics.<ref name=rovery>{{cite journal |vauthors=Rovery C, Brouqui P, Raoult D |title=Questions on Mediterranean Spotted Fever a Century after Its Discovery|journal=Emerg Infect Dis |volume=14 |pages=1360–1367 |year=2008 |doi=10.3201/eid1409.071133 |issue=9 |pmid=18760001 |pmc=2603122}}</ref><ref>{{cite journal |author1=Conor, A |author2=A Bruch|title=Une fièvre éruptive observée en Tunisie|journal=Bull Soc Pathol Exot Filial |volume=8 |pages=492–496 |year=1910}}</ref>


==Presentation==
==Presentation==
After an incubation period of around seven days, the disease manifests abruptly with chills, high fevers, muscular and articular pains, severe headache and [[photophobia]]. The location of the bite forms a black ulcerous crust (tache noire). Around the fourth day of the illness an [[exanthem]] (widespread rash) appears, first [[macular]] and then [[maculopapular]] and sometimes [[petechial]].
After an incubation period around seven days, the disease manifests abruptly with chills, high fevers, muscular and articular pains, severe headache, and [[photophobia]]. The location of the bite forms a black, ulcerous crust (''tache noire''). Around the fourth day of the illness, a [[exanthema|widespread rash]] appears, first [[macular]] and then [[maculopapular]], and sometimes [[petechial]].{{cn|date=May 2021}}


==Diagnosis==
==Diagnosis==
The diagnosis is made with [[serologic]] methods, either the classic [[Weil-Felix test]]
The diagnosis is made with [[serologic]] methods, either the classic [[Weil–Felix test]], ([[Agglutination (biology)|agglutination]] of ''Proteus'' OX strains), [[ELISA]], or [[immunofluorescence]] assays in the bioptic material of the primary lesion.
The Weil–Felix test demonstrated low sensitivity (33%) in diagnosing acute rickettsial infections and low specificity, with a positive titre of 1:320 seen in 54% of healthy volunteers and 62% of non-rickettsial fever patients. Therefore, the use of the WFT should be discouraged in the diagnosis of acute rickettsial infections.{{cn|date=May 2021}}
([[Agglutination (biology)|agglutination]] of Proteus OX strains ), [[ELISA]] or [[immunofluorescence]] assays in the bioptic material of the primary lesion.


==Treatment==
==Treatment==
The illness can be treated with [[Tetracycline antibiotics|tetracycline]]s ([[doxycycline]] is the preferred treatment), [[chloramphenicol]], [[macrolides]] or [[fluoroquinolones]].
The illness can be treated with [[Tetracycline antibiotics|tetracycline]]s ([[doxycycline]] is the preferred treatment), [[chloramphenicol]], [[macrolides]], or [[fluoroquinolones]].{{cn|date=May 2021}}


==See also==
==See also==
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{{reflist}}
{{reflist}}


==External links==
== External links ==
{{Medical resources
* [http://cchs-dl.slis.ua.edu/clinical/infectious/byorganism/rickettsial/mediterranean.htm Mediterranean Spotted Fever Clinical Resources]
| ICD10 = {{ICD10|A|77|1|a|75}}
| ICD9 = {{ICD9|082.1}}
| ICDO =
| OMIM =
| DiseasesDB = 31780
| MedlinePlus =
| eMedicineSubj =
| eMedicineTopic =
| MeshID = D001907
}}


{{Bacterial diseases}}
{{Bacterial diseases}}
{{Tick-borne diseases}}
{{Tick-borne diseases}}
{{Bacterial cutaneous infections}}


{{DEFAULTSORT:Boutonneuse Fever}}
{{DEFAULTSORT:Boutonneuse Fever}}
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[[Category:Tick-borne diseases]]
[[Category:Tick-borne diseases]]
[[Category:Rickettsioses]]
[[Category:Rickettsioses]]

{{infectious-disease-stub}}

[[es:Fiebre botonosa mediterránea]]
[[fr:Fièvre boutonneuse méditerranéenne]]
[[nl:Fièvre boutonneuse]]
[[tr:Fièvre Boutonneuse]]

Latest revision as of 00:34, 18 April 2024

Boutonneuse fever
Other namesMediterranean spotted fever
Typical eschar and spots on the leg of a patient with Boutonneuse fever[1]
SpecialtyInfectious disease

Boutonneuse fever (also called Mediterranean spotted fever, fièvre boutonneuse, Kenya tick typhus, Indian tick typhus, Marseilles fever, or Astrakhan fever) is a fever as a result of a rickettsial infection caused by the bacterium Rickettsia conorii and transmitted by the dog tick Rhipicephalus sanguineus. Boutonneuse fever can be seen in many places around the world, although it is endemic in countries surrounding the Mediterranean Sea. This disease was first described in Tunisia in 1910 by Conor and Bruch and was named boutonneuse (French for "spotty") due to its papular skin-rash characteristics.[1][2]

Presentation

[edit]

After an incubation period around seven days, the disease manifests abruptly with chills, high fevers, muscular and articular pains, severe headache, and photophobia. The location of the bite forms a black, ulcerous crust (tache noire). Around the fourth day of the illness, a widespread rash appears, first macular and then maculopapular, and sometimes petechial.[citation needed]

Diagnosis

[edit]

The diagnosis is made with serologic methods, either the classic Weil–Felix test, (agglutination of Proteus OX strains), ELISA, or immunofluorescence assays in the bioptic material of the primary lesion. The Weil–Felix test demonstrated low sensitivity (33%) in diagnosing acute rickettsial infections and low specificity, with a positive titre of 1:320 seen in 54% of healthy volunteers and 62% of non-rickettsial fever patients. Therefore, the use of the WFT should be discouraged in the diagnosis of acute rickettsial infections.[citation needed]

Treatment

[edit]

The illness can be treated with tetracyclines (doxycycline is the preferred treatment), chloramphenicol, macrolides, or fluoroquinolones.[citation needed]

See also

[edit]

References

[edit]
  1. ^ a b Rovery C, Brouqui P, Raoult D (2008). "Questions on Mediterranean Spotted Fever a Century after Its Discovery". Emerg Infect Dis. 14 (9): 1360–1367. doi:10.3201/eid1409.071133. PMC 2603122. PMID 18760001.
  2. ^ Conor, A; A Bruch (1910). "Une fièvre éruptive observée en Tunisie". Bull Soc Pathol Exot Filial. 8: 492–496.
[edit]