[Mediterranean spotted fever in north Dalmatia: is there a problem?].
We analyzed clinical and therapeutic characteristics of Mediterranean spotted fever (MSF) in north Dalmatia. Analysis was conducted in 93 patients hospitalized with MSF at Zadar General Hospital during the 1988-2000 period. The most frequently found signs of the disease were high fever (91; 97.8%), maculopapular rash (89; 95.7%), headaches (84; 90.3%), arthralgia (75; 80.6%), exhaustion (75; 80.6%) and nausea (65; 69.9%). Tache noire, as a pathognomonic sign of MSF, was found in 22 (23.7%) patients. The most frequently indicated diagnoses were febris cum exanthemate (43; 46.2), rickettsiosis suspecta (21; 22.6%) and exanthema maculopapulosum (15; 16.1%). Early therapeutic efficiency was achieved by doxycycline in 34/43 (79.1%), and by ciprofloxacin in 10/14 (71.4%) treated adult patients, and by azithromycin in 7/9 (77.8%) children. The identification of MSF endemic rickettsiosis in north Dalmatia, serious clinical forms of the disease and the success of early and adequate anti-rickettsial antibiotic therapy are a clear warning that our physicians must be very familiar with this disease and include this rickettsial disease in differential diagnosis of acute febrile diseases accompanied by rash.
Odjel za lijejenje zaraznih bolesti, Opća bolnica Zadar, Medicinski fakultet Split. boris.dzelalija@zd.t-com.hr
Boris
B
Dzelalija
Alan
A
Medić
Toni
T
Lozancić
D001907:Boutonneuse Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male