Cases of Mediterranean spotted fever in southeast of Iran
In this study the clinical manifestations, laboratory findings, and management of five patients diagnosed with Mediterranean spotted fever (MSF) from southeast of Iran are presented. All patients but one had recent thick-bite histories which were noticeable as black eschars (tache noire). Patients’ samples were tested by real-time PCR and serology (IFA). The disease was confirmed by fourfold rising of IgG antibodies against Rickettsia conorii. This is the first report of MSF cases in Iran.
2. Creus BF, Cueto FB, Arenas EE, Sanahuja RV, Espin TM, Salas MN, et al. Mediterranean spotted fever: a cooperative study of 227 cases. Rev Infect Dis 1985;7:635-642.
3. Figueira-Coelho J, Martins T, Machado J, Maltez F. Atypical case of Mediterranean spotted fever. Braz J Infect Dis 2010;14:213-216.
4. Parola P, Paddock CD, Socolovschi C, Labruna MB, Mediannikov O, Kernif T, et al. Update on tick-borne rickettsioses around the world: a geographic approach. Clin Microbiol Rev 2013;26:657-702.
5. Fard SN, Ghashghaei OO, Khalili M, Sharifi H. Tick diversity and detection of Coxiella burnetii in tick of small ruminants using nested Trans PCR in southeast Iran. Trop Biomed 2016;33:506-511.
6. Parola P, Socolovschi C, Jeanjean L, Bitam I, Fournier P-E, Sotto A, et al. Warmer weather linked to tick attack and emergence of severe rickettsioses. PLoS Negl Trop Dis 2008;2(11): e338.
7. Rovery C, Raoult D. Mediterranean spotted fever. Infect Dis Clin North Am 2008;22:515-530, ix.
8. Wallménius K (2016). Studies of Spotted Fever Rickettsia-Distribution, Detection, Diagnosis and Clinical Context: With a Focus on Vectors and Patients in Sweden: Acta Univ Ups.
9. Kovacova E, Sixl W, Stunzner D, Urvolgyi J, Kazar J. Serological examination of human and animal sera from six countries of three continents for the presence of rickettsial antibodies. Eur J Epidemiol 1996;12:85-89.
10. El-Naggari MA, Idris A, Al-Muharrmi Z, El-Nour I. Rickettsial infection diagnosed in a clinical context in Oman. Sultan Qaboos Univ Med J 2016;16(4): e529-e530.
11. Kissenkötter J, Hansen S, Böhlken-Fascher S, Ademowo OG, Oyinloye OE, Bakarey AS, et al. Development of a pan-rickettsial molecular diagnostic test based on recombinase polymerase amplification assay. Anal Biochem 2018;544:29-33.
12. Brouqui P, Bacellar F, Baranton G, Birtles R, Bjoersdorff A, Blanco J, et al. Guidelines for the diagnosis of tick-borne bacterial diseases in Europe. Clin Microbiol Infect 2004;10:1108-1132.
13. de Sousa R, Nobrega SD, Bacellar F, Torgal J. Mediterranean spotted fever in Portugal: risk factors for fatal outcome in 105 hospitalized patients. Ann N Y Acad Sci 2003;990:285-294.
14. Parhizgari N, Gouya MM, Mostafavi EJIjom. Emerging and re-emerging infectious diseases in Iran. Iran J Microbiol 2017;9:122-142.
15. Centers for Disease Control and Prevention (CDC). Imported Spotted Fevers 2017 [updated April 13, 2017. Available from: https://www.cdc.gov/otherspottedfever/imported/index.html
16. Rovery C, Brouqui P, Raoult D. Questions on Mediterranean spotted fever a century after its discovery. Emerg Infect Dis 2008;14:1360-1367.
17. Karasartova D, Gureser AS, Gokce T, Celebi B, Yapar D, Keskin A, et al. Bacterial and protozoal pathogens found in ticks collected from humans in Corum province of Turkey. PLoS Negl Trop Dis 2018;12(4):e0006395.