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LABORATORY-CONFIRMED MEDITERRANEAN SPOTTED FEVER IN A JAPANESE TRAVELER TO KENYA

A Japanese traveler returning from Kenya became ill, presenting with fever and a prominent, generalized rash without an eschar. Results of the immunofluorescence antibody assay of the patient’s sera performed in Japan were compatible with illness due to a spotted fever group (SFG) rickettsia, and a presumptive diagnosis of African SFG rickettsiosis, probably either Mediterranean spotted fever (MSF) or African tick-bite fever (ATBF), was rendered. To further define the disease diagnosis, sera were examined in France by Western immunoblotting combined with cross-adsorption, which confirmed the diagnosis of MSF but not of ATBF. Because of the need to further characterize the epidemiologic and clinical features of the two African SFG rickettsioses, clinicians are encouraged to contact a specialized laboratory when encountering such cases.

Received April 20, 2005. Accepted for publication July 25, 2005.

Financial support: This study was conducted in part as a "Research on Health Sciences Focusing on Drug Innovation" (KH42075) funded by The Japan Health Sciences Foundation.

^* Address correspondence to Mikio Kimura, Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan. E-mail: kimumiki{at}nih.go.jp

Authors’ addresses: Hiroko Yoshikawa, Department of Infectious Diseases, Niigata City General Hospital, 2-6-1 Schichikuyama, Nii-gata 950-8739, Japan, Telephone: +81-25-241-5151, Fax: +81-25-248-3507. Mikio Kimura, Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan, Telephone: +81-3-5285-1111 ext. 2043, Fax: +81-3-5285-1129, E-mail: kimumiki{at}nih.go.jp. Motohiko Ogawa, Department of Virology 1, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan, Telephone: +81-3-5285-1111 ext. 2563, Fax: +81-3-5285-1208. Jean-Marc Rolain and Didier Raoult, Unité des Rickettsies, CNRS UMR6020, Faculté de Médecine, Université de la Méditerranée, 27, boulevard Jean Moulin, 13385 Marseilles Cédex 5, France, Telephone: +33-491-324375, Fax: +33-491-830390.

Reprint requests: Mikio Kimura, Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan, Telephone: +81-3-5285-1111 ext. 2043, Fax: +81-3-5285-1129, E-mail: kimumiki{at}nih.go.jp.