[Clinical and epidemiological study of spotted fever group rickettsiosis in Albacete, Spain]. / Estudio clínico-epidemiológico de las rickettsiosis del grupo de las fiebres exantemáticas en Albacete.

INTRODUCTION: 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. CONCLUSION: 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.

Estudio clínico-epidemiológico de las rickettsiosis del grupo de las fiebres exantemáticas en Albacete / Clinical and epidemiological study of spotted fever group rickettsiosis in Albacete, Spain

INTRODUCCIÓN. El objetivo de este trabajo es describir las características clínicas y epidemiológicas de las rickettsiosis del grupo de las fiebres exantemáticas adquiridas en la provincia de Albacete. MÉTODOS. Se revisaron retrospectivamente las historias clínicas de los pacientes que tuvieron un diagnóstico de rickettsiosis del grupo de las fiebres exantemáticas con serología positiva entre 1997 y 2003. Los criterios de inclusión fueron los siguientes: 1) seroconversión en inmunoglobulina G (IgG) frente a Rickettsia conorii por inmunofluorescencia indirecta (IFI) o 2) un título igual o superior a 160 con 2 o 3 de los siguientes síntomas: fiebre, mancha negra, exantema. RESULTADOS. Hubo 41 casos en el período de estudio. La edad media fue 58 años (intervalo: 14-84). Treinta y siete (90%)pacientes tenían 40 o más años de edad (riesgo relativo [RR]:10,1; intervalo de confianza del 95 % [IC 95%]: 4,3-24,0).Veinticinco (63%) pacientes eran de procedencia rural (RR:3,5; IC 95%: 1,8-6,5). Treinta y seis (88%) pacientes habían tenido contacto habitual o reciente con el medio rural o con animales. Cuarenta pacientes tuvieron fiebre y 38 (93%)presentaron una o dos escaras. Hubo 32 casos de fiebre botonosa mediterránea, 2 casos compatibles con DEBONEL/TIBOLA y 7 casos atípicos con escara y sin exantema. CONCLUSIÓN. Las rickettsiosis del grupo de las fiebres exantemáticas se diagnosticaron principalmente en adultos en contacto con el medio rural o con animales. La edad superior a 40 años y la residencia en el medio rural fueron factores de riesgo. La fiebre botonosa mediterránea fue el síndrome más frecuente (AU)

INTRODUCTION. 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) serocon version in IgG to Rickettsia conorii by indirect immunofluorescence, or 2) a single titer of >= 160 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. CONCLUSION. 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 wasthe most common síndrome (AU)