[Clinical and epidemiological study of spotted fever group rickettsiosis in Albacete, Spain].
BACKGROUND
The aim of this study was to describe the clinical and epidemiological features of spotted fever group rickettsiosis acquired in the province of Albacete, Spain.


METHODS
We retrospectively reviewed the clinical records of patients with a diagnosis of spotted fever group rickettsiosis and positive serologic results between 1997 and 2003. Criteria for inclusion were as follows: 1) seroconversion in IgG to Rickettsia conorii by indirect immunofluorescence, or 2) a single titer of 160 dollars with two or three of the following symptoms: fever, eschar, or rash.


RESULTS
There were 41 cases in the study period. Mean age was 58 years (range: 14-84). Thirty-seven (90%) patients were 40 or more years old (RR: 10,1; 95% CI: 4,3-24,0). Twenty-five (63%) patients were of rural origin (RR: 3,5; 95% CI: 1,8-6,5). Thirty-six (88%) patients had regular or recent contact with the rural milieu or with animals. Forty patients had fever and 38 (93%) had one or two eschars. There were 32 cases of Mediterranean spotted fever, 2 cases with symptoms consistent with DEBONEL/TIBOLA, and 7 atypical cases with eschar and no rash.


CONCLUSIONS
Spotted fever group rickettsiosis was mainly found in adults in contact with the rural milieu or with animals. Age over 40 years old and residence in a rural area were risk factors. Mediterranean spotted fever was the most common syndrome.
Bartolomé
Joaquín
J
Laboratorio de Microbiología, Complejo Hospitalario Universitario de Albacete, España. jbartolome@sescam.jccm.es
Lorente
Santiago
S
Hernández-Pérez
Noelia
N
Martínez-Alfaro
Elisa
E
Marín-Ors
Amparo
A
Crespo
María Dolores
MD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D001096:Arachnid Vectors / Q000382:microbiology; D001733:Bites and Stings / Q000150:complications; D001907:Boutonneuse Fever / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D004197:Disease Reservoirs; D004285:Dogs; D005076:Exanthema / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D008206:Lymphatic Diseases / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011817:Rabbits; D012282:Rickettsia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D020114:Rickettsia conorii / Q000276:immunology / Q000302:isolation & purification; D012307:Risk Factors; D012423:Rural Health; D016036:Seroepidemiologic Studies; D013030:Spain / Q000453:epidemiology; D017282:Tick-Borne Diseases / Q000453:epidemiology / Q000382:microbiology; D013987:Ticks / Q000382:microbiology
D000907:Antibodies, Bacterial