title: [Malignant form of Mediterranean boutonneuse fever. 6 cases].
abstract: Six cases of severe Mediterranean boutonneuse fever are reported. The clinical diagnosis, based on the presence of summer fever with an erythematous rash plus an escharr in three patients, was confirmed by serology (microagglutination in 1 case, indirect immunofluorescence in 4). The symptoms resembled those of Rocky Mountain spotted fever associating, as they did, a purpuric rash with neurological signs (impaired consciousness in all 6 cases, convulsion in 2), respiratory symptoms (5) and digestive signs (diarrhoea in 1 case, enlargement of the liver in 4). Laboratory examinations showed thrombopenia (6), rise in serum transaminases (5), LDH (5) and CPK (6), increased in blood urea and creatinine levels (6), hyponatraemia (6), hypokaliaemia (5) and hypocalcaemia (5). Two patients treated with doxycycline recovered and 4 died. Among these, 1 had received erythromycin, 1 a tetracycline and 1 doxycycline.
mesh_terms: D000293:Adolescent; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001907:Boutonneuse Fever / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012288:Rickettsiaceae Infections / Q000175:diagnosis*; D012698:Serologic Tests; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: La forme maligne de la fièvre boutonneuse méditerranéenne. Six observations.