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

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  • 1 Department of Infectious Diseases, Niigata City General Hospital, Niigata, Japan; Infectious Disease Surveillance Center and Department of Virology 1, National Institute of Infectious Diseases, Tokyo, Japan; Unité des Rickettsies, CNRS UMR6020, Faculté de Médecine, Université de la Méditerranée, Marseilles, France

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.

Author Notes

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@nih.go.jp.
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