title: Mediterranean spotted fever in crete, Greece: clinical and therapeutic data of 15 consecutive patients.
abstract: The clinical, epidemiological, and therapeutic aspects of 15 patients with Mediterranean spotted fever (MSF), admitted to the Internal Medicine Department of the General Hospital of Sitia (southeastern Crete, Greece) between December 2000 and July 2003, were studied. Diagnosis was made on the basis of clinical signs and symptoms and was confirmed by serology. Of the patients studied, 67% were men and 33% women, with a median age of 52 years (range of 23-76 years). Ten cases (67%) were diagnosed between May and July. Of all the patients, 93% had a history of contact with animals, mainly with sheep (11 patients, 73%), while 53% of them had a history of tick-bite (33%), or reported the presence of ticks in their environment (20%). The typical eschar lesion (tache noir) at the tick-bite site was present in 53% of the patients, while the rash was present in 87% of them. Laboratory findings included leukopenia (47%), thrombocytopenia (54%), elevation of transaminases (80%), hyponatremia (33%), and microscopic hematuria (80%). Four patients (27%) displayed pulmonary infiltrates on chest radiography. All patients were treated with doxycycline (200 mg daily) and recovered rapidly. Renal function deteriorated in one patient with chronic renal failure, but he recovered thereafter.
authors.affiliation: University of Crete, Faculty of Medicine, Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine (WHO Collaborating Center for Research and Training in Mediterranean Zoonoses), Crete, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Germanakis
authors.forename: A
authors.initials: A
authors.lastname: Psaroulaki
authors.forename: A
authors.initials: A
authors.lastname: Gikas
authors.forename: Y
authors.initials: Y
authors.lastname: Tselentis
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001907:Boutonneuse Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy / Q000635:transmission; D005260:Female; D005843:Geography; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007299:Insect Bites and Stings / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D020114:Rickettsia conorii / Q000302:isolation & purification; D013987:Ticks / Q000382:microbiology