title: Mediterranean spotted fever in southeastern Romania.
abstract: Although cases of Mediterranean spotted fever (MSF) have been reported for decades in southeastern Romania, there are few published data. We retrospectively studied 339 patients, diagnosed with MSF at the National Institute of Infectious Diseases "Prof. Dr. Matei Bals" between 2000 and 2011, in order to raise awareness about MSF in certain regions of Romania. According to the Raoult diagnostic criteria 171 (50.4%) had a score >25 points. Mean age was 52.5 years. One hundred and fifty-five (90.6%) patients were from Bucharest and the surrounding region. Almost all patients presented with fever (99.4%) and rash (98.2%), and 57.9% had evidence of a tick bite. There were no recorded deaths. Serologic diagnosis was made by indirect immunofluorescence assay. Of the 171 patients, serology results for R. conorii were available in 147. One hundred and twenty-three (83.7%) of them had a titer IgG ≥1:160 or a fourfold increase in titer in paired samples. MSF is endemic in southeastern Romania and should be considered in patients with fever and rash even in the absence of recognized tick exposure. Since the disease is prevalent in areas highly frequented by tourists, travel-associated MSF should be suspected in patients with characteristic symptoms returning from the endemic area.
authors.affiliation: National Institute of Infectious Diseases "Prof. Dr. Matei Bals", 021105 Bucharest, Romania ; Carol Davila University of Medicine and Pharmacy, 020022 Bucharest, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pitigoi
authors.forename: Ioana D
authors.initials: ID
authors.lastname: Olaru
authors.forename: Daniela
authors.initials: D
authors.lastname: Badescu
authors.forename: Alexandru
authors.initials: A
authors.lastname: Rafila
authors.forename: Victoria
authors.initials: V
authors.lastname: Arama
authors.forename: Adriana
authors.initials: A
authors.lastname: Hristea
mesh_terms: D000293:Adolescent; D000328:Adult; D001907:Boutonneuse Fever / Q000097:blood / Q000453:epidemiology* / Q000473:pathology* / Q000635:transmission; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012383:Romania; D064927:Tick Bites
chemical_list: D007074:Immunoglobulin G
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