Mediterranean spotted fever-like illness in Sardinia, Italy: a clinical and microbiological study.
Infection
; 44(6): 733-738, 2016 Dec.
Article
en En
| MEDLINE
| ID: mdl-27380385
ABSTRACT
INTRODUCTION:
Rickettsioses represent a group of emerging infectious diseases in Europe. Climate changes and the anthropization of rural environment have favored vectors' biological cycle and geographic spread. In Sardinia, Mediterranean spotted fever (MSF) is endemic and represents an important public health problem.PURPOSE:
We investigated the etiology and the clinical presentation of MSF-like illness in northern Sardinia by enrolling patients admitted to the Infectious Disease Unit of the University of Sassari.RESULTS:
Diagnostic tests included ELISA, Indirect immunofluorescence (IFI), DNA isolation from blood and from eschar samples with real-time PCR and genotyping. Eighty-seven patients with a mean age of 53 ± 14 years, of whom 65 (75 %) males, were included in the study. The most common diagnosis was MSF (79 %), followed by Q fever (8 %), and anaplasmosis (2 %). A tache noire was found in 58 % of rickettioses and 28 % of Coxiella burnetii infections. MSF was confirmed in 47 % of the cases by IFI and 43 % by ELISA antibody tests. The isolation of rickettsial DNA from the eschar was positive in 10/13 (77 %) of the cases due to Rickettsia conorii. Using this method, we identified the first case of R. monacensis infection in Italy.CONCLUSIONS:
In conclusion, antibody-based tests confirmed the diagnosis in less than 50 % of the cases, whereas DNA isolation confirmed the diagnosis in 77 % of tested cases and allowed the identification of a new pathogenic species in Italy. Therefore, DNA isolation should be implemented to better identify the etiology of MSF-like illnesses and help the clinician in the management of patients.Palabras clave
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Banco de datos:
MEDLINE
Asunto principal:
Fiebre Botonosa
/
Rickettsia conorii
Tipo de estudio:
Prognostic_studies
Límite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
País como asunto:
Europa
Idioma:
En
Año:
2016
Tipo del documento:
Article