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Mediterranean Spotted Fever: Clinical, Laboratory and Epidemiological Features of 199 Cases

Didier Raoult^*,**,, Pierre J. Weiller, André Chagnon, Hervé Chaudet, Hervé Gallais^* AND Paul Casanova^*

^* Clinique des Maladies Infectieuses, Hôpital Félix Houphouët Boigny, 416 Chemin de la Madrague Ville, 13015 Marseille, France
^** Unité des Rickettsies, Laboratoire de Bactériologie, Groupe Hospitalier de la Timone, Boulevard Jean Moulin, 13385 Marseille Cedex 5
C.H.U. La Timone, 13385 Marseille Cedex 5
Hôpital Sainte Anne, 83800 Toulon Naval
Laboratoire de Biomathématiques, Statistiques Médicales et Épidémiologiques, Informatique, C.H.U. La Timone, 13385 Marseille Cedex 5

Most previous studies of Mediterranean spotted fever (MSF) have included cases that either were not laboratory-confirmed or were confirmed by the Weil-Felix test. The authors report the detailed clinical, laboratory and epidemiological features of 199 serologically-confirmed cases of MSF (by microimmunofluorescence). This work demonstrates that the disease is difficult to diagnose, especially at the beginning; that it can be fatal (2.5% of cases); and that a rapid and specific diagnosis is necessary to identify atypical cases.

Epidemiological features such as season (summer essentially), presence of a dog, and travel in an endemic area (the Mediterranean Basin) are important in the diagnosis. In such cases fever associated with rash have to be considered and treated as MSF.

Accepted for publication February 5, 1986.

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