Boutonneuse Fever Treatment & Management
- Author: Anna Zalewska, MD, PhD; Chief Editor: Dirk M Elston, MD more...
Medical Care
- Patients with the benign form of boutonneuse fever are usually treated with antibiotics for 7 days.
- Patients with the malignant form of boutonneuse fever are usually treated with antibiotics for 2 weeks.
- Tetracyclines with chloramphenicol and quinolones may be considered first-line antibiotics for boutonneuse fever.
Consultations
The differential diagnosis for boutonneuse fever includes many rare diseases. Consider consultations with a dermatologist and an infectious disease specialist.
Brouqui P, Parola P, Fournier PE, Raoult D. Spotted fever rickettsioses in southern and eastern Europe. FEMS Immunol Med Microbiol. Feb 2007;49(1):2-12. [Medline].
Valbuena G, Walker DH. Expression of CX3CL1 (fractalkine) in mice with endothelial-target rickettsial infection of the spotted-fever group. Virchows Arch. Jan 2005;446(1):21-7. [Medline].
Rydkina E, Sahni A, Baggs RB, Silverman DJ, Sahni SK. Infection of human endothelial cells with spotted Fever group rickettsiae stimulates cyclooxygenase 2 expression and release of vasoactive prostaglandins. Infect Immun. Sep 2006;74(9):5067-74. [Medline].
de Sousa R, Ismail N, Nobrega SD, 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. Sep 1 2007;196(5):770-81. [Medline].
Damas JK, Davì G, Jensenius M, et al. Relative chemokine and adhesion molecule expression in Mediterranean spotted fever and African tick bite fever. J Infect. Jan 2009;58(1):68-75. [Medline].
Palau LA, Pankey GA. Mediterranean Spotted Fever in Travelers from the United States. J Travel Med. Dec 1 1997;4(4):179-182. [Medline].
Jufresa J, Alegre J, Surinach JM, et al. [Study of 86 cases of Mediterranean boutonneuse fever hospitalized at a university hospital]. An Med Interna. Jul 1997;14(7):328-31. [Medline].
Segura-Porta F, Diestre-Ortin G, Ortuno-Romero A, et al. Prevalence of antibodies to spotted fever group rickettsiae in human beings and dogs from and endemic area of mediterranean spotted fever in Catalonia, Spain. Eur J Epidemiol. Jun 1998;14(4):395-8. [Medline].
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. Jun 2003;990:285-94. [Medline].
Mert A, Ozaras R, Tabak F, Bilir M, Ozturk R. Mediterranean spotted fever: a review of fifteen cases. J Dermatol. Feb 2006;33(2):103-7. [Medline].
Cascio A, Iaria C. Epidemiology and clinical features of Mediterranean spotted fever in Italy. Parassitologia. Jun 2006;48(1-2):131-3. [Medline].
Choi YJ, Jang WJ, Ryu JS, et al. Spotted fever group and typhus group rickettsioses in humans, South Korea. Emerg Infect Dis. Feb 2005;11(2):237-44. [Medline].
Tijsse-Klasen E, Jameson LJ, Fonville M, Leach S, Sprong H, Medlock JM. First detection of spotted fever group rickettsiae in Ixodes ricinus and Dermacentor reticulatus ticks in the UK. Epidemiol Infect. Apr 2011;139(4):524-9. [Medline].
Chipp E, Digby S. Rickettsia: an unusual cause of sepsis in the emergency department. Emerg Med J. Nov 2006;23(11):e60. [Medline].
Ezpeleta D, Munoz-Blanco JL, Tabernero C, Gimenez-Roldan S. [Neurological complications of Mediterranean boutonneuse fever. Presentation of a case of acute encephalomeningomyelitis and review of the literature]. Neurologia. Jan 1999;14(1):38-42. [Medline].
Jenkins DR, Rees JC, Pollitt C, Cant A, Craft AW. Mediterranean spotted fever mimicking Kawasaki disease. BMJ. Mar 1 1997;314(7081):655-6. [Medline].
Broadhurst LE, Kelly DJ, Chan CT, et al. Laboratory evaluation of a dot-blot enzyme immunoassay for serologic confirmation of illness due to Rickettsia conorii. Am J Trop Med Hyg. Jun 1998;58(6):786-9. [Medline].
Ergas D, Zev Sthoeger M, Keysary A, Strenger C, Leitner M, Zimhony O. Early diagnosis of severe Mediterranean spotted fever cases by nested-PCR detecting spotted fever Rickettsiae 17-kD common antigen gene. Scand J Infect Dis. 2008;40(11-12):965-7. [Medline].
Dzelalija B, Petrovec M, Avsic-Zupanc T, Strugar J, Milic TA. Randomized trial of azithromycin in the prophylaxis of Mediterranean spotted fever. Acta Med Croatica. 2002;56(2):45-7. [Medline].
Demeester R, Claus M, Hildebrand M, Vlieghe E, Bottieau E. Diversity of life-threatening complications due to Mediterranean spotted fever in returning travelers. J Travel Med. Mar-Apr 2010;17(2):100-4. [Medline].
Aliaga L, Sanchez-Blazquez P, Rodriguez-Granger J, Sampedro A, Orozco M, Pastor J. Mediterranean spotted fever with encephalitis. J Med Microbiol. Apr 2009;58:521-5. [Medline].
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. Feb 2003;22(2):126-8. [Medline].
Bentov Y, Sheiner E, Kenigsberg S, Mazor M. Mediterranean spotted fever during pregnancy: case presentation and literature review. Eur J Obstet Gynecol Reprod Biol. Apr 25 2003;107(2):214-6. [Medline].
Cohen J, Lasri Y, Landau Z. Mediterranean spotted fever in pregnancy. Scand J Infect Dis. 1999;31(2):202-3. [Medline].
Buscemi S, D'Orio L, Sgroi C. [Clinical characteristics and therapeutic perspectives of boutonneuse fever. Assessment of a caseload of 39 patients]. Ann Ital Med Int. Jan-Mar 1997;12(1):11-4. [Medline].
Caroleo S, Longo C, Pirritano D, et al. A case of acute quadriplegia complicating Mediterranean spotted fever. Clin Neurol Neurosurg. Jun 2007;109(5):463-5. [Medline].
Cascio A, Dones P, Romano A, Titone L. Clinical and laboratory findings of boutonneuse fever in Sicilian children. Eur J Pediatr. Jun 1998;157(6):482-6. [Medline].
Corazza M, Bertelli G, Altieri E, Strumia R. Mediterranean spotted fever: a case report. J Eur Acad Dermatol Venereol. Nov 1999;13(3):229-30. [Medline].
Dignat-George F, Tissot-Dupont H, Grau GE, Camoin-Jau L, Raoult D, Sampol J. Differences in levels of soluble E-selectin and VCAM-1 in malignant versus non malignant Mediterranean spotted fever. Thromb Haemost. Dec 1999;82(6):1610-3. [Medline].
Elghetany MT, Walker DH. Hemostatic changes in Rocky Mountain spotted fever and Mediterranean spotted fever. Am J Clin Pathol. Aug 1999;112(2):159-68. [Medline].
La Scola B, Raoult D. Diagnosis of Mediterranean spotted fever by cultivation of Rickettsia conorii from blood and skin samples using the centrifugation-shell vial technique and by detection of R. conorii in circulating endothelial cells: a 6-year follow-up. J Clin Microbiol. Nov 1996;34(11):2722-7. [Medline].
Mansueto S, Vitale G, Mocciaro C, et al. Modifications of general parameters of immune activation in the sera of Sicilian patients with Boutonneuse fever. Clin Exp Immunol. Mar 1998;111(3):555-8. [Medline].
Milano S, D'Agostino P, Di Bella G, et al. Interleukin-12 in human boutonneuse fever caused by Rickettsia conorii. Scand J Immunol. Jul 2000;52(1):91-5. [Medline].
Psaroulaki A, Loukaidis F, Hadjichristodoulou C, Tselentis Y. Detection and identification of the aetiological agent of Mediterranean spotted fever (MSF) in two genera of ticks in Cyprus. Trans R Soc Trop Med Hyg. Nov-Dec 1999;93(6):597-8. [Medline].
Vitale G, Mansueto S, Gambino G, et al. The acute phase response in Sicilian patients with boutonneuse fever admitted to hospitals in Palermo, 1992-1997. J Infect. Jan 2001;42(1):33-9. [Medline].

