title: Mediterranean spotted fever presenting as an acute pancreatitis.
abstract: Mediterranean spotted fever (MSF) is an infectious disease, caused by Rickettsia conorii. It can have a serious course, even deadly, with many types of complications. Described is a case of a 70-year-old man, hospitalized for fever, abdominal pain, amylase and lipase elevation, and ultrasound hypoechoic pancreas. The working diagnosis at admission was acute pancreatitis. 2 days after admission, the patient developed signs of MSF: fever, maculopapular rash, and "tache noire". Treatment with oral doxycycline was started. After 5 days of therapy, there was complete remission of epigastric pain and fever. Gastrointestinal and hepatic complications are described in association with Mediterranean spotted fever. Much more rare is pancreatic involvement.
authors.affiliation: Emergency Unit, "Beato Angelo" Hospital, Acri, Cosenza, Italy and Internal and Emergency Medicine Unit, Vibo Valentia Hospital, Italy. f.rombola@alice.it
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Rombola
mesh_terms: D000208:Acute Disease; D000368:Aged; D001907:Boutonneuse Fever / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D007558:Italy; D008297:Male; D010195:Pancreatitis / Q000175:diagnosis*