boutonneuse fever

Summary

Summary: A febrile disease of the Mediterranean area, the Crimea, Africa, and India, caused by infection with RICKETTSIA CONORII.

Top Publications

  1. Matsumoto K, Brouqui P, Raoult D, Parola P. Experimental infection models of ticks of the Rhipicephalus sanguineus group with Rickettsia conorii. Vector Borne Zoonotic Dis. 2005;5:363-72 pubmed
    ..The harmful effect of R. conorii on Rh. sanguineus group ticks from Thailand is discussed including the role of the geographic origin of the ticks and the difficulties to identify ticks within this group to the species level...
  2. Ezpeleta D, Muñoz Blanco J, Tabernero C, Gimenez Roldan S. [Neurological complications of Mediterranean boutonneuse fever. Presentation of a case of acute encephalomeningomyelitis and review of the literature]. Neurologia. 1999;14:38-42 pubmed
    ..We review the neurological syndromes reported in association with R. conorii infection. Our case is the second described as acute myelopathy complicating Mediterranean spotted fever...
  3. Vitale G, Mansueto S, Gambino G, Mocciaro C, Spinelli A, Rini G, et al. The acute phase response in Sicilian patients with boutonneuse fever admitted to hospitals in Palermo, 1992-1997. J Infect. 2001;42:33-9 pubmed
    To study the modifications of some components of the acute phase response (APR) in Sicilian patients with boutonneuse fever (BF) caused by Rickettsia conorii.
  4. Balistreri C, Candore G, Lio D, Colonna Romano G, Di Lorenzo G, Mansueto P, et al. Role of TLR4 receptor polymorphisms in Boutonneuse fever. Int J Immunopathol Pharmacol. 2005;18:655-60 pubmed
    ..We genotyped for +896A/G TLR4 polymorphism 78 patients affected with Boutonneuse fever, 78 age-matched controls and 78 advanced age individuals from Sicily...
  5. de Sousa R, Ismail N, Nobrega S, Franca A, Amaro M, Anes M, et al. Intralesional expression of mRNA of interferon- gamma , tumor necrosis factor- alpha , interleukin-10, nitric oxide synthase, indoleamine-2,3-dioxygenase, and RANTES is a major immune effector in Mediterranean spotted fever rickettsiosis. J Infect Dis. 2007;196:770-81 pubmed
    ..The mechanisms of immunity to Rickettsia conorii that have been elucidated in mouse models have not been evaluated in human tissues...
  6. Vishwanath S, McDonald G, Watkins N. A recombinant Rickettsia conorii vaccine protects guinea pigs from experimental boutonneuse fever and Rocky Mountain spotted fever. Infect Immun. 1990;58:646-53 pubmed
    There are no vaccines against boutonneuse fever and Rocky Mountain spotted fever...
  7. Punda Polic V, Luksic B, Capkun V. Epidemiological features of Mediterranean spotted fever, murine typhus, and Q fever in Split-Dalmatia County (Croatia), 1982-2002. Epidemiol Infect. 2008;136:972-9 pubmed
    ..We found no statistically significant differences between season- and gender-specific incidence rates of MT. Whereas infections due to rickettsiae decreased, the incidence of Q fever increased over the last 12 years of the study...
  8. Bouyer D, Stenos J, Crocquet Valdes P, Moron C, Popov V, Zavala Velazquez J, et al. Rickettsia felis: molecular characterization of a new member of the spotted fever group. Int J Syst Evol Microbiol. 2001;51:339-47 pubmed publisher
    ..felis as a member of the SFG. The organism is passed trans-stadially and transovarially, and infection in the cat flea has been observed in the midgut, tracheal matrix, muscle, hypodermis, ovaries and testes...
  9. Brouqui P, Parola P, Fournier P, Raoult D. Spotted fever rickettsioses in southern and eastern Europe. FEMS Immunol Med Microbiol. 2007;49:2-12 pubmed
    ..Finally, the mite-transmitted Rickettsia akari, the agent of rickettsialpox, is also known to be prevalent in Europe. We present here an overview of these rickettsioses, focusing on emerging diseases...

More Information

Publications84

  1. Cardeñosa N, Segura F, Raoult D. Serosurvey among Mediterranean spotted fever patients of a new spotted fever group rickettsial strain (Bar29). Eur J Epidemiol. 2003;18:351-6 pubmed
    ..The epidemiological implications of spotted fever caused by R. conorii and by rickettsial strain Bar29 in the Catalonia deserve further studies with isolation and characterization of more rickettsial strains...
  2. Leitner M, Yitzhaki S, Rzotkiewicz S, Keysary A. Polymerase chain reaction-based diagnosis of Mediterranean spotted fever in serum and tissue samples. Am J Trop Med Hyg. 2002;67:166-9 pubmed
    ..The results demonstrate that sera and tissue samples are suitable specimens for the nested PCR tests, especially in fatal cases...
  3. Mumcuoglu K, Keysary A, Gilead L. Mediterranean spotted fever in Israel: a tick-borne disease. Isr Med Assoc J. 2002;4:44-9 pubmed
  4. Damås J, Davi G, Jensenius M, Santilli F, Otterdal K, Ueland T, et al. Relative chemokine and adhesion molecule expression in Mediterranean spotted fever and African tick bite fever. J Infect. 2009;58:68-75 pubmed publisher
    ..We hypothesized that different inflammatory potential in endothelial cells could contribute to the different clinical features in these rickettsioses...
  5. Sréter Lancz Z, Széll Z, Kovacs G, Egyed L, Marialigeti K, Sréter T. Rickettsiae of the spotted-fever group in ixodid ticks from Hungary: identification of a new genotype ('Candidatus Rickettsia kotlanii'). Ann Trop Med Parasitol. 2006;100:229-36 pubmed
    ..Current knowledge on the distributions of the rickettsiae of the spotted-fever group that are emerging in Europe is also summarized...
  6. de Sousa R, Nobrega S, Bacellar F, Torgal J. Mediterranean spotted fever in Portugal: risk factors for fatal outcome in 105 hospitalized patients. Ann N Y Acad Sci. 2003;990:285-94 pubmed
    ..Although one may speculate that the pathogenic strain of Israeli tick typhus, isolated in 1997, could be responsible for this increase of fatality rate, inherited patient factors might also be strongly associated with mortality...
  7. Aharonowitz G, Koton S, Segal S, Anis E, Green M. Epidemiological characteristics of spotted fever in Israel over 26 years. Clin Infect Dis. 1999;29:1321-2 pubmed
    ..Thus, even during periods of low incidence, careful monitoring and high awareness for prompt diagnosis and treatment are needed...
  8. Keysary A, Potasman I, Itzhaki A, Finkelstein R, Yitzhaki S, Strenger C, et al. Clusters of Mediterranean spotted fever in Israel. Vector Borne Zoonotic Dis. 2007;7:143-6 pubmed
    ..MSF was diagnosed in the recovered patients by serology. The diagnosis of MSF fever in one family member should raise the awareness to the possibility of other cases in the vicinity...
  9. Alioua Z, Bourazza A, Lamsyah H, Erragragui Y, Boudi O, Karouach K, et al. [Neurological feature of Mediterranean spotted fever: a study of four cases]. Rev Med Interne. 2003;24:824-9 pubmed
    ..Rickettsia conorii is the etiologic agent of Mediterranean spotted fever that is endemic in Mediterranean...
  10. Parra Martínez J, Sancho Rieger J, Ortiz Sánchez P, Peset V, Brocalero A, Castillo A, et al. [Encephalitis caused by Rickettsia conorii without exanthema]. Rev Neurol. 2002;35:731-4 pubmed
    Mediterranean boutonneuse fever, caused by Rickettsia conorii, is an endemic disease in the Mediterranean area. The serious forms of the disease, which include encephalitis, are infrequent but are associated with a high mortality rate...
  11. Chai J, Eremeeva M, Borland C, Karas J. Fatal Israeli spotted fever in a UK traveler to South Portugal. J Travel Med. 2008;15:122-3 pubmed publisher
    ..She subsequently died, and polymerase chain reaction of a blood sample was positive for Rickettsia conorii ssp israeliensis. The prevalence of severe forms of this illness in the Mediterranean Basin is discussed...
  12. Papa A, Dalla V, Petala A, Maltezou H, Maltezos E. Fatal Mediterranean spotted fever in Greece. Clin Microbiol Infect. 2010;16:589-92 pubmed publisher
    ..Physicians have to be aware of MSF in patients with severe disease who are returning from the Mediterranean area...
  13. Colomba C, Saporito L, Polara V, Rubino R, Titone L. Mediterranean spotted fever: clinical and laboratory characteristics of 415 Sicilian children. BMC Infect Dis. 2006;6:60 pubmed
    ..The aim of the study was to analyze the clinical and laboratory characteristics of patients with MSF and the efficacy of the drugs administered...
  14. Cascio A, Colomba C, Antinori S, Paterson D, Titone L. Clarithromycin versus azithromycin in the treatment of Mediterranean spotted fever in children: a randomized controlled trial. Clin Infect Dis. 2002;34:154-8 pubmed
    ..Azithromycin, because it has a long half-life, offers the advantages of administration in a single daily dose and a shorter duration of therapy, which could increase compliance in children...
  15. Kuloglu F, Rolain J, Akata F, Eroglu C, Celik A, Parola P. Mediterranean spotted fever in the Trakya region of Turkey. Ticks Tick Borne Dis. 2012;3:298-304 pubmed publisher
    ..While IFA allows for retrospective diagnosis in MSF, advanced molecular techniques provide the rapid detection of rickettsia in all skin samples, including eschar and maculopapular rash...
  16. Stenos J, Walker D. The rickettsial outer-membrane protein A and B genes of Rickettsia australis, the most divergent rickettsia of the spotted fever group. Int J Syst Evol Microbiol. 2000;50 Pt 5:1775-9 pubmed publisher
    ..R. australis rOmpB is more similar to rOmpB of other SFG rickettsiae than to that of typhus group rickettsiae...
  17. Cascio A, Dones P, Romano A, Titone L. Clinical and laboratory findings of boutonneuse fever in Sicilian children. Eur J Pediatr. 1998;157:482-6 pubmed
    The spectrum of signs and symptoms of 645 consecutive children diagnosed from 1984 to 1996 with boutonneuse fever (BF), a mild rickettsial disease caused by Rickettsia conorii endemic in the Mediterranean basin, are reported...
  18. Bernabeu Wittel M, Del Toro M, Nogueras M, Muniain M, Cardenosa N, Marquez F, et al. Seroepidemiological study of Rickettsia felis, Rickettsia typhi, and Rickettsia conorii infection among the population of southern Spain. Eur J Clin Microbiol Infect Dis. 2006;25:375-81 pubmed
    ..3; 95%CI 3.7-23.2), and participation in outdoor activities (OR=7.2; 95%CI 1.4-38.5). The results confirm the widespread prevalence of past infection due to R. felis, R. typhi, and R. conorii in the population of southern Spain...
  19. Rovery C, Brouqui P, Raoult D. Questions on Mediterranean spotted fever a century after its discovery. Emerg Infect Dis. 2008;14:1360-7 pubmed publisher
    ..Moreover, MSF has become more severe than RMSF; the mortality rate was as high as 32% in Portugal in 1997. Whether Rhipicephalus sanguineus is the only vector and reservoir for R. conorii conorii is a question not yet answered...
  20. de Sousa R, Luz T, Parreira P, Santos Silva M, Bacellar F. Boutonneuse fever and climate variability. Ann N Y Acad Sci. 2006;1078:162-9 pubmed
    Researchers have long appreciated the role of climate in vector-borne diseases, including the resurgence of boutonneuse fever (BF). Portugal usually is classified as having temperate Mediterranean climate...
  21. Colomba C, Saporito L, Siracusa L, Giammanco G, Bonura S, Titone L. [Mediterranean spotted fever in paediatric and adult patients: two clinical aspects of the same disease]. Infez Med. 2011;19:248-53 pubmed
    ..Analysis of the results confirms that MSF is a benign, and self-limiting disease in children, while severe complications can often arise in adults...
  22. Thijssen H, Leroy P, van t Hek L, Hurkx G. [An unsuspected imported disease: meningo-encephalitis contracted in Spain]. Ned Tijdschr Geneeskd. 2004;148:113-7 pubmed
    ..Knowledge of local epidemiology and good communication with the locally consulted medical system are essential for a correct diagnosis and therefore for appropriate treatment and a good prognosis...
  23. Anton E, Font B, Munoz T, Sanfeliu I, Segura F. Clinical and laboratory characteristics of 144 patients with mediterranean spotted fever. Eur J Clin Microbiol Infect Dis. 2003;22:126-8 pubmed
  24. Solano Gallego L, Kidd L, Trotta M, Di Marco M, Caldin M, Furlanello T, et al. Febrile illness associated with Rickettsia conorii infection in dogs from Sicily. Emerg Infect Dis. 2006;12:1985-8 pubmed
    ..We report serologic and molecular evidence of acute, febrile illness associated with Rickettsia conorii in 3 male Yorkshire terriers from Sicily (Italy)...
  25. Simser J, Palmer A, Fingerle V, Wilske B, Kurtti T, Munderloh U. Rickettsia monacensis sp. nov., a spotted fever group Rickettsia, from ticks (Ixodes ricinus) collected in a European city park. Appl Environ Microbiol. 2002;68:4559-66 pubmed
    ..rickettsii. R. monacensis joins a growing list of SFG rickettsiae that colonize ticks but whose infectivity and pathogenicity for vertebrates are unknown...
  26. Barrio J, de Diego A, Ripoll C, Perez Calle J, Nunez O, Salcedo M, et al. Mediterranean spotted fever in liver transplantation: a case report. Transplant Proc. 2002;34:1255-6 pubmed
  27. Cascio A, Colomba C, Di Rosa D, Salsa L, di Martino L, Titone L. Efficacy and safety of clarithromycin as treatment for Mediterranean spotted fever in children: a randomized controlled trial. Clin Infect Dis. 2001;33:409-11 pubmed
    ..7 h in the clarithromycin group and 47.1 h in the chloramphenicol group (P=.047). Clarithromycin could be an acceptable therapeutic alternative to chloramphenicol and to tetracyclines for children aged <8 years with MSF...
  28. Fournier P, Zhu Y, Ogata H, Raoult D. Use of highly variable intergenic spacer sequences for multispacer typing of Rickettsia conorii strains. J Clin Microbiol. 2004;42:5757-66 pubmed
    ..conorii isolates. Our study supports the usefulness of MST for strain genotyping. This tool may be useful for tracing a strain and identifying its source during outbreaks, including those resulting from bioterrorism...
  29. Fournier P, Jensenius M, Laferl H, Vene S, Raoult D. Kinetics of antibody responses in Rickettsia africae and Rickettsia conorii infections. Clin Diagn Lab Immunol. 2002;9:324-8 pubmed
    ..We recommend that sera collected 4 weeks after the onset of signs of patients with suspected African tick-bite fever should be used for the definitive serological diagnosis of R. africae infections...
  30. Madeddu G, Mancini F, Caddeo A, Ciervo A, Babudieri S, Maida I, et al. Rickettsia monacensis as cause of Mediterranean spotted fever-like illness, Italy. Emerg Infect Dis. 2012;18:702-4 pubmed publisher
  31. Baltadzhiev I, Popivanova N. Some epidemiological features of the Mediterranean spotted fever re-emerging in Bulgaria. Folia Med (Plovdiv). 2012;54:36-43 pubmed
    ..The epidemiologic characteristics of MSF in the region are in support of its prevention and control. ..
  32. Frean J, Blumberg L. Tick bite fever and Q fever - a South African perspective. S Afr Med J. 2007;97:1198-202 pubmed
    ..Chronic Q fever remains challenging to treat. ..
  33. Sentausa E, El Karkouri K, Robert C, Raoult D, Fournier P. Genome sequence of Rickettsia conorii subsp. indica, the agent of Indian tick typhus. J Bacteriol. 2012;194:3288-9 pubmed publisher
    ..Rickettsia conorii subsp. indica is the agent of Indian tick typhus. The present study reports the draft genome of Rickettsia conorii subsp. indica strain ITTR (ATCC VR-597). ..
  34. Giammanco G, Vitale G, Mansueto S, Capra G, Caleca M, Ammatuna P. Presence of Rickettsia conorii subsp. israelensis, the causative agent of Israeli spotted fever, in Sicily, Italy, ascertained in a retrospective study. J Clin Microbiol. 2005;43:6027-31 pubmed
    ..The recorded clinical data of the five ISF patients support the idea that these strains could correlate to more-severe forms of human disease. Three of five patients experienced severe disease, and one of them died...
  35. Chaudhry D, Garg A, Singh I, Tandon C, Saini R. Rickettsial diseases in Haryana: not an uncommon entity. J Assoc Physicians India. 2009;57:334-7 pubmed
    ..All were successfully treated with doxycycline. ..
  36. Khairallah M, Zaouali S, Ben Yahia S, Ladjimi A, Messaoud R, Jenzeri S, et al. Anterior ischemic optic neuropathy associated with rickettsia conorii infection. J Neuroophthalmol. 2005;25:212-4 pubmed
    ..This infection should be considered in a patient with nonarteritic anterior ischemic optic neuropathy with high fever or skin rash who inhabits or travels from an endemic area...
  37. Papa A, Chaligiannis I, Xanthopoulou K, Papaioakim M, Papanastasiou S, Sotiraki S. Ticks parasitizing humans in Greece. Vector Borne Zoonotic Dis. 2011;11:539-42 pubmed publisher
    ..2%. The increased aggressiveness of R. sanguineus might be related to the weather conditions occurred during 2007-2008, while a variety of factors, including climate, might play a role in CCHF emergence. ..
  38. Vene S. Diagnosis of rickettsial infections in Swedish patients: detection of specific IgM. Eur J Epidemiol. 1989;5:436-7 pubmed
    ..The microimmunofluorescence test was a simple and reliable tool in the detection of specific IgM for a rapid and accurate diagnosis of C. burnetii-and R. conorii-infections early in the course of disease. ..
  39. Oristrell J, Sampere M, Amengual M, Font B, Segura F. Plasma interleukin-6 levels in Mediterranean spotted fever. Eur J Clin Microbiol Infect Dis. 2004;23:417-8 pubmed
  40. Bentov Y, Sheiner E, Kenigsberg S, Mazor M. Mediterranean spotted fever during pregnancy: case presentation and literature review. Eur J Obstet Gynecol Reprod Biol. 2003;107:214-6 pubmed
    ..During pregnancy, the treatment of choice for Mediterranean spotted fever is chloramphenicol, but it seems that Azithromycin could be another possible option. ..
  41. Beltrame A, Angheben A, Casolari S, Castelli F, Magnani G, Gaiera G, et al. Imported rickettsioses in Italy. Travel Med Infect Dis. 2012;10:201-4 pubmed publisher
    ..Prior to receiving the laboratory results, physicians should start empirical treatment on the basis of epidemiologic data (e.g., travel history to Africa), and clinical findings compatible with rickettsioses (e.g., eschars). ..
  42. Beninati T, Lo N, Noda H, Esposito F, Rizzoli A, Favia G, et al. First detection of spotted fever group rickettsiae in Ixodes ricinus from Italy. Emerg Infect Dis. 2002;8:983-6 pubmed
    ..Using molecular methods, we detected three different spotted fever group rickettsiae, including Rickettsia helvetica. Our results raise the possibility that bacteria other than R. conorii are involved in rickettsial diseases in Italy. ..
  43. Boulahri T, Taous A, Berri M, Traibi I, Elbenaye J, Rouimi A. [Rickettsiosis associated with cerebral infarction: a new case study]. Pan Afr Med J. 2017;26:80 pubmed publisher
  44. Gillespie J, Beier M, Rahman M, Ammerman N, Shallom J, Purkayastha A, et al. Plasmids and rickettsial evolution: insight from Rickettsia felis. PLoS ONE. 2007;2:e266 pubmed
  45. Sousa R, Nobrega S, Bacellar F, Torgal J. [Epidemiologic features of Mediterranean spotted fever in Portugal]. Acta Med Port. 2003;16:429-36 pubmed
    ..6 deaths per 100,000 inhabitants have occurred. Although is an obligatory notifiable disease, high number of underreported cases are detected. ..
  46. Raoult D, Toga B, Chaudet H, Chiche Portiche C. Rickettsial antibody in southern France: antibodies to Rickettsia conorii and Coxiella burnetii among urban, suburban and semi-rural blood donors. Trans R Soc Trop Med Hyg. 1987;81:80-1 pubmed
    ..This supports the view that in the south of France the highest prevalence of Mediterranean Spotted Fever is suburban. 5% of the sera had antibodies to Coxiella burnetti in this area, in which Q fever is endemic...
  47. Colomba C, Saporito L, Colletti P, Mazzola G, Rubino R, Pampinella D, et al. Atrial fibrillation in Mediterranean spotted fever. J Med Microbiol. 2008;57:1424-6 pubmed publisher
    ..Our patient was previously healthy and had no reported history of cardiac disease. This suggests that heart function should be monitored in MSF patients even in the absence of underlying risk factors. ..
  48. Reshef R, Levo Y, Giladi M. African tick bite fever in a returned traveler. Isr Med Assoc J. 2007;9:680-1 pubmed
  49. Rolain J, Shpynov S, Raoult D. Spotted-fever-group rickettsioses in north Asia. Lancet. 2003;362:1939 pubmed
  50. Popivanova N, Murdjeva M, Baltadzhiev I, Haydushka I. Dynamics in serum cytokine responses during acute and convalescent stages of Mediterranean spotted fever. Folia Med (Plovdiv). 2011;53:36-43 pubmed
    ..The role of cytokines in MSF is still in the focus of research due to their complex participation in the immune pathogenesis of the disease...
  51. Bougteba A, Basir A, Charradi N. [Meningoencephalitis caused by Rickettsia conorii in a young infant]. Rev Neurol (Paris). 2011;167:173-6 pubmed publisher
    ..The physiopathology of Mediterranean spotted fever includes diffuse vasculitis with endothelial injury. Early diagnosis and specific antibiotic treatment may reduce the risk of complications. ..
  52. Quesada M, Sanfeliu I, Cardeñosa N, Segura F. Ten years' experience of isolation of Rickettsia spp. from blood samples using the shell-vial cell culture assay. Ann N Y Acad Sci. 2006;1078:578-81 pubmed
    ..Rickettsia isolation using all blood samples as well as DNA from shell-vial lenses could be useful in the study of rickettsial infections...
  53. Astrup E, Lekva T, Davi G, Otterdal K, Santilli F, Oie E, et al. A complex interaction between Rickettsia conorii and Dickkopf-1--potential role in immune evasion mechanisms in endothelial cells. PLoS ONE. 2012;7:e43638 pubmed publisher
    ..conorii-induced inflammation in endothelial cells could potentially reflect a novel mechanism by which R. conorii escapes the immune response at the site of infection...
  54. Segura F, Anton E. Clarithromycin for the treatment of Mediterranean spotted fever. Clin Infect Dis. 2002;34:560 pubmed
  55. Morita C, El Hussein A, Matsuda E, Abdel Gabbar K, Muramatsu Y, Abdel Rahman M, et al. Spotted fever group rickettsiae from ticks captured in Sudan. Jpn J Infect Dis. 2004;57:107-9 pubmed
    ..In this study, we succeeded in detecting the SFG rickettsiae gene in ticks, and established that there were at least two species of SFG rickettsiae in field ticks in Sudan...
  56. Botelho Nevers E, Rovery C, Richet H, Raoult D. Analysis of risk factors for malignant Mediterranean spotted fever indicates that fluoroquinolone treatment has a deleterious effect. J Antimicrob Chemother. 2011;66:1821-30 pubmed publisher
    ..To identify risk factors for malignant Mediterranean spotted fever (MSF) caused by Rickettsia conorii conorii...
  57. Chelbi F, Hammami S, Sghaier S, Hamzaoui A, Mahjoub S. [Transient monoclonal hypergammaglobulinemia in the course of a Rickettsia conorii infection]. Med Mal Infect. 2005;35:228-9 pubmed
  58. Grzybowski A. Ludwik Fleck's studies in microbiology. Wurzbg Medizinhist Mitt. 2007;26:110-9 pubmed
  59. Curiel Balsera E, Prieto Palomino M, Mora Ordóñez J, Muñoz Bono J. [Boutonneuse fever with severe neurological involvement]. Med Intensiva. 2007;31:104 pubmed
  60. Chipp E, Digby S. Rickettsia: an unusual cause of sepsis in the emergency department. Emerg Med J. 2006;23:e60 pubmed
    ..Emergency clinicians should be aware of the possible diagnosis in travellers returning from endemic areas in order to start the correct treatment as early as possible and minimise subsequent complications and mortality...
  61. Mouffok N, Parola P, Lepidi H, Raoult D. Mediterranean spotted fever in Algeria--new trends. Int J Infect Dis. 2009;13:227-35 pubmed publisher
    ..We report herein a prospective study conducted in Oran, the second largest city in Algeria. This disease has not been properly described in Oran or in other Algerian cities...
  62. Blanco J, Oteo J. Rickettsiosis in Europe. Ann N Y Acad Sci. 2006;1078:26-33 pubmed
    ..Other rickettsioses exist that have not yet been implicated in human pathology. We should consider that climate changes and other factors could contribute to the emergence and reemergence of other new diseases...
  63. Kasimova N, Kulikova I, Karpenko S, Burkin V, Altukhov S, Arshba T, et al. [Status of cellular immunity in patients with Astrakhan fever]. Ter Arkh. 2002;74:23-6 pubmed
    ..To ascertain regularities of development of cellular immunity in patients with Astrakhan fever (AF) with reference to AF severity, treatment and course...
  64. Owen H, Clark P, Stenos J, Robertson I, Fenwick S. Potentially pathogenic spotted fever group rickettsiae present in Western Australia. Aust J Rural Health. 2006;14:284-5 pubmed
  65. Pardo M, Espejo E, Colomé A, Bella F. [Demyelinating polyneuropathy after Rickettesia conorii infection]. Med Clin (Barc). 2008;130:798-9 pubmed
  66. Anton E, Muñoz T, Travería F, Navarro G, Font B, Sanfeliu I, et al. Randomized Trial of Clarithromycin for Mediterranean Spotted Fever. Antimicrob Agents Chemother. 2015;60:1642-5 pubmed publisher
    ..75 ± 3.08 days in the doxycycline/josamycin (P = NS). There were no adverse reactions to treatment or relapses in either group. In conclusion, clarithromycin is a good alternative to doxycycline or josamycin in the treatment of MSF. ..
  67. Leone S, De Marco M, Ghirga P, Nicastri E, Lazzari R, Narciso P. Retinopathy in Rickettsia conorii infection: case report in an immunocompetent host. Infection. 2008;36:384-6 pubmed
    ..MSF is considered a relatively benign disease, but severe complications occur occasionally. However, reports of ocular involvement are few. We describe a case of retinal manifestation in a patient with R. conorii infection...
  68. Rydkina E, Turpin L, Sahni A, Sahni S. Regulation of inducible heme oxygenase and cyclooxygenase isozymes in a mouse model of spotted fever group rickettsiosis. Microb Pathog. 2012;53:28-36 pubmed publisher
  69. Fernández Soto P, Perez Sanchez R, Díaz Martín V, Encinas Grandes A, Alamo Sanz R. Rickettsia massiliae in ticks removed from humans in Castilla y León, Spain. Eur J Clin Microbiol Infect Dis. 2006;25:811-3 pubmed
  70. de Almeida D, Favacho A, Rozental T, Barcaui H, Guterres A, Gomes R, et al. Fatal spotted fever group rickettsiosis due to Rickettsia conorii conorii mimicking a hemorrhagic viral fever in a South African traveler in Brazil. Ticks Tick Borne Dis. 2010;1:149-50 pubmed publisher
    ..SFGR was confirmed by molecular and immunohistochemical analyses...
  71. Serban R, Pistol A, Neguţ M, Cucuiu R. [Rickettsia conorii infection in Romania, 2000-2008]. Bacteriol Virusol Parazitol Epidemiol. 2009;54:177-83 pubmed
    ..presenting the epidemiological aspects of Rickettsia conorii infection in Romania between 2000-2008...
  72. Oztoprak N, Celebi G, Aydemir H, Piskin N, Bektas S, Koca R, et al. [Mediterranean spotted fever due to contact with dog-tick]. Mikrobiyol Bul. 2008;42:701-6 pubmed
  73. Tzavella K, Chatzizisis Y, Hatzizisis I, Vakali A, Mandraveli K, Zioutas D, et al. Severe case of Mediterranean spotted fever in Greece with predominantly neurological features. J Med Microbiol. 2006;55:341-3 pubmed
    ..Diagnosis was confirmed later, during the second week after disease onset, by detection of elevated titres of IgM and IgG antibodies against R. conorii using an indirect immunofluorescence assay...
  74. Dzelalija B, Petrovec M, Gasparov S, Avsic Zupanc T. The first fatal case of Mediterranean spotted fever in Croatia. Acta Med Croatica. 2000;54:195-7 pubmed
    ..Serologic findings indicated that Rickettsia conorii infection was the etiologic cause of the patient's death...
  75. Ruiz Ruiz F, Perez Calvo J, Hualde Enguita A, Amores Ferreras M. [Fever and cutaneous necrotic lesion]. Rev Clin Esp. 2005;205:565-6 pubmed