Mediterranean Spotted Fever: Retrospective Review of Hospitalized Cases and Predictive Factors of Severe Disease

• Autor(a) principal: Meireles, Mariana
• Data de Publicação: 2015
• Outros Autores: Magalhães, Rui, Guimas, Arlindo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5992
• topic: Boutonneuse Fever; Prognosis; Rickettsia conorii; Rickettsia Infections; Risk Factors.; Factores de Risco; Febre escaro-nodular; Infecções por Rickettsia; Prognóstico; Rickettsia conorii.

Introduction: Mediterranean spotted fever, an ancient zoonotic disease raising current issues. This study aims to reevaluate the disease clinical picture and to identify prognostic factors related to severe disease.Material and Methods: We evaluate cases admitted to a central hospital during 12-year period. The risk factors were determined by uni and multivariate analysis, comparing patients admitted in general infirmary versus intermediate/intensive care units or in case of death.Results: We reviewed 71 cases of Mediterranean spotted fever. The mean age was 63.3 ± 16.7 years and 52.1% were male. The eschar was observed in 62.0%. Fever and rash were the most common clinical findings. Forty five percent of patients developed complications and 22.5% were admitted to intermediate and/or intensive care units. Apyrexia, dyspnea, renal failure and elevated lactic dehydrogenase levels at admission were predictors of severe disease development (p < 0.034). Alcoholism was related with prolonged hospitalization (p = 0.020). Absence of fever (p = 0.019) and elevated serum creatinine levels (p = 0.028) were identified as independent factors associated with severe outcome. The mortality rate was 2.8%.Discussion: Although Mediterranean spotted fever is usually assumed to be benign, severe cases are emerging.Conclusion: Early identification of the infection and continuous patient surveillance are crucial, particularly in those with greater risk of developing severe or fatal disease.