Search Our Scientific Publications & Authors

S Afr Med J 2021 Mar 31;111(4):307-308. Epub 2021 Mar 31.

Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.

Acute disseminated encephalomyelitis (ADEM) is an immune-mediated acute inflammatory demyelinating disorder, which typically occurs after viral infections or immunisation. We present a case of a man with acute Rickettsia conorii infection whose diagnosis was delayed. He presented with fever, headache, an eschar and an acute paraplegia. Read More

Med Princ Pract 2021 Mar 29. Epub 2021 Mar 29.

Background: Mediterranean spotted fever (MSF) is a tick-borne rickettsial infection endemic to the Mediterranean coastline countries. As a result of growing tourism imported cases have been registered in many non-endemic countries and regions.

Objective: We present clinical laboratory parameters and histopathological data on renal impairment in patients with MSF. Read More

Parasite Immunol 2021 May 15;43(5):e12830. Epub 2021 Apr 15.

Center for Molecular and Cellular Biosciences, School of Biological. Environmental, and Earth Sciences, University of Southern Mississippi, Hattiesburg, MS, USA.

Ticks are haematophagous arthropods with unique molecular mechanisms for digesting host blood meal while acting as vectors for various pathogens of public health significance. The tick's pharmacologically active saliva plays a fundamental role in modulating the host's immune system for several days to weeks, depending on the tick species. The vector tick has also developed sophisticated molecular mechanisms to serve as a competent vector for pathogens, including the spotted fever group (SFG) rickettsiae. Read More

BMJ Case Rep 2021 Feb 23;14(2). Epub 2021 Feb 23.

Laniado Hospital, Sanz Medical Centre, Netanya, Israel.

A young healthy gardener became febrile with abdominal pain, nausea, vomiting and diarrhoea followed by palpable purpura, mostly on the legs and buttocks with associated arthralgia. Dehydration, azotemia and hyponatraemia resolved with fluid replacement. Tests demonstrated acute pancreatitis, hepatitis, thrombocytopenia, microscopic haematuria and proteinuria. Read More

Enferm Infecc Microbiol Clin 2021 Feb 19. Epub 2021 Feb 19.

Servicio de Pediatría, Hospital Universitario de Getafe, Madrid, España.

Cutis 2020 Nov;106(5):233-235

Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, USA.

The human flea, Pulex irritans, is an important vector in the transmission of human diseases. This flea has been identified as a vector for the bubonic plague as far back as the 14th century, causing millions of deaths. Pulex irritans also has been identified as a vector for Bartonella bacteria species, which can cause trench fever. Read More

Open Forum Infect Dis 2020 Oct 13;7(10):ofaa355. Epub 2020 Aug 13.

Internal Medicine Department F, Galilee Medical Center, Nahariya, Israel.

A 29-year-old female presented with fever, headache, and epigastric pain. Though her initial presentation was benign and nonspecific, she soon developed a full-blown cytokine storm with disseminated intravascular coagulation. She was diagnosed with hemophagocytosis secondary to infection. Read More

Cent Eur J Public Health 2020 Sep;28(3):187-192

Medical University, Plovdiv, Bulgaria.

Objectives: Mediterranean spotted fever (MSF) is a tick-borne endemic disease caused by Rickettsia conorii conorii and transmitted to humans by the brown dog tick Rhipicephalus sanguineus. It is characterized by fever, maculopapular rash and a tick bite skin lesion "tache noire". The disease affects all age groups and usually has mild to moderate course. Read More

Ticks Tick Borne Dis 2020 11 4;11(6):101536. Epub 2020 Aug 4.

Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal; Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal. Electronic address:

Dogs are highly exposed to pathogens transmitted by ectoparasites. The Mediterranean climate of Southern Europe, together with the presence of stray and/or neglected pets in close proximity with humans, contribute for tick expansion and stand for increased risk to infections in humans due to the zoonotic potential of many of these agents. The aim of this study was to perform a molecular survey in dogs (suspected of tick-borne disease and/or infested with ticks), as well as in ticks collected from those animals, from 12 districts of Portugal to investigate the occurrence of Rickettsia spp. Read More

An Pediatr (Barc) 2020 Dec 18;93(6):429. Epub 2020 Jul 18.

Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España.

Iran J Microbiol 2020 Jun;12(3):256-260

Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

In this study the clinical manifestations, laboratory findings, and management of five patients diagnosed with Mediterranean spotted fever (MSF) from southeast of Iran are presented. All patients but one had recent tick-bite histories which were noticeable as black eschars (tache noire). Patients' samples were tested by real-time PCR and serology (IFA). Read More

New Microbes New Infect 2020 Jul 3;36:100704. Epub 2020 Jun 3.

S.I. Georgievsky Medical Academy (Academic Unit), V.I. Vernadsky Crimean Federal University, Simferopol, Russia.

The occurrence of Mediterranean fever with periods of increase and decrease has been recorded in the Crimean peninsula. The city of Sevastopol and its vicinity are known endemic areas for this disease. Some of the most active agents in the spread of this rickettsiosis are feral and abandoned dogs. Read More

Acta Parasitol 2020 Dec 15;65(4):999-1004. Epub 2020 Jun 15.

Istituto Zooprofilattico Sperimentale Della Sardegna "G. Pegreffi", Sassari, Italy.

Purpose: In recent decades, the incidence and distribution of tick-borne diseases have increased worldwide, attracting the attention of both clinicians and veterinarians. In Sardinia, notifiable tick-borne diseases are spreading and Mediterranean spotted fever (MSF) rickettsiosis continues to be endemic with an incidence of 10/10,000 inhabitants per year. Furthermore, ticks can transfer more than one pathogen after a single blood meal from a coinfected host or after multiple feeding on different infected hosts. Read More

Parasit Vectors 2020 Apr 21;13(1):118. Epub 2020 Apr 21.

Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, PD, Italy.

Background: The ability of tick-borne agents to survive in stored blood bags is a key factor for their transmissibility by blood transfusion. The aim of this study was to evaluate the survival and potential infectivity of Rickettsia conorii (RC) in artificially contaminated canine whole blood (WB) and in leukoreduced whole blood (LR-WB) during the storage period.

Methods: RC was cultured on L929 cells. Read More

Am J Pathol 2020 02 16;190(2):306-322. Epub 2020 Jan 16.

Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas; Institute for Translational Sciences, University of Texas Medical Branch, Galveston, Texas; Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, Texas. Electronic address:

Mediterranean spotted fever is a reemerging acute tick-borne infection produced by the α-proteobacterium, Rickettsia conorii. Rickettsia conorii infects vascular endothelial cells producing disseminated plasma leakage, manifesting as nonspecific fever, headache, and maculopapular rash. Because there are no available tests of early infection, Mediterranean spotted fever is often undiagnosed and untreated, resulting in significant mortality. Read More

Ticks Tick Borne Dis 2020 03 3;11(2):101353. Epub 2019 Dec 3.

Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Spain; National Centre for Epidemiology, Instituto de Salud Carlos III, Calle De Melchor Fernández Almagro, 5, 28029, Madrid, Spain.

Background: Mediterranean spotted fever (MSF) is a zoonotic disease caused by Rickettsia conorii and transmitted by Rhipicephalus sanguineus sensu lato. The aim of this study is to understand the epidemiology and trends regarding the disease in Spain, based on notifications to the Spanish National Epidemiology Surveillance Network (RENAVE) and the National Hospital Discharge Database (CMBD) between 2005 and 2015.

Methods: We carried out a retrospective cross-sectional study of the cases and the outbreaks reported to the RENAVE and of those found in the CMBD between January 1, 2005 and December 31, 2015. Read More

Dermatopathology (Basel) 2019 Apr-Jun;6(2):70-76. Epub 2019 Jun 26.

School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

The rickettsiae are a diverse group of vector-borne zoonotic bacterial pathogens. The two common spotted fever diseases in existence in southern Africa are boutonneuse fever-like tick bite fever (TBF), caused by , and African TBF, caused by . This review addresses demographic, epidemiological, clinical, diagnostic, therapeutic, and preventive aspects of TBF in the southern African context, including a discussion of the dermatopathological findings and potential diagnostic pitfalls. Read More

Klin Lab Diagn 2019 ;64(9):553-559

Office of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in the Altai Republic, 649002, Gorno-Altaisk, Russia.

The real epidemiological impact of Spotted Fever Group rickettsioses including Siberian tick-borne typhus (STT) in Russia is not sufficiently studied. One of the reasons is the actual absence of either certified domestic diagnostic kits or the evidence for using foreign test kits for laboratory verification of this group of tick-borne infections in medical practice. Objective of our study was to study the diagnostic accuracy of the ELISA test system based on Rickettsia conorii antigens for serological verification of STT. Read More

PLoS Negl Trop Dis 2019 08 29;13(8):e0007469. Epub 2019 Aug 29.

Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU Mediterranée-Infection, Marseille, France.

As a result of migrations and globalization, people may face a possible increase in the incidence of central nervous system rickettsial infections (CNS R). These diseases, caused by Rickettsia species and transmitted to humans by arthropod bites, are putatively lethal. However, the diagnosis of CNS R is challenging and often delayed due to their nonspecific clinical presentation and the strict intracellular nature of rickettsiae. Read More

Acta Parasitol 2019 Dec 6;64(4):769-778. Epub 2019 Dec 6.

Department of Infectious Animal Diseases and Bee Diseases, Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia.

Purpose: The incidence of vector-borne zoonoses has been increasing in Europe as a result of global climate change, and rickettsioses are a significant etiologic entity among these infections. The objective of this study was to investigate the seroprevalences of Rickettsia conorii, Ehrlichia canis and Coxiella burnetii in dogs in Montenegro.

Methods: The seroepidemiological study covered 259 dogs, of which 155 were owned dogs suspected of infection with agents of rickettsial aetiology from the continental (Podgorica) or five coastal municipalities of Montenegro (Budva, Herceg Novi, Kotor, Ulcinj and Bar), and 104 dogs were from a public shelter in Podgorica. Read More

Klin Lab Diagn 2019 ;64(6):354-359

N.F. Gamaleya National Research Center for Epidemiology and Microbiology, 123098, Moscow, Russia.

723 blood sera from 537 patients of Regional Infectious Clinical Hospital, Astrakhan were obtained during high activity period of Rhipicephalus ticks (May-September 2015) and retrospectively studied for IgG/IgM to antigen of spotted fever group (SFG) Rickettsia. IgG and/or IgM to Rickettsia conorii were detected in 145 sera from 130 patients, and antibodies to R. sibirica (group-specific) were detected in 143 sera from 145. Read More

Med Mal Infect 2019 Aug 13;49(5):318-334. Epub 2019 May 13.

Maladies infectieuses et tropicales, centre hospitalo-universitaire, 30000 Nîmes, France.

Lyme borreliosis is transmitted en France by the tick Ixodes ricinus, endemic in metropolitan France. In the absence of vaccine licensed for use in humans, primary prevention mostly relies on mechanical protection (clothes covering most parts of the body) that may be completed by chemical protection (repulsives). Secondary prevention relies on early detection of ticks after exposure, and mechanical extraction. Read More

Front Cell Infect Microbiol 2019 10;9:97. Epub 2019 Apr 10.

Vector Borne Disease Laboratories, Department of Pathobiological Sciences, LSU School of Veterinary Medicine, Baton Rouge, LA, United States.

Despite their high degree of genomic similarity, different spotted fever group (SFG) are often associated with very different clinical presentations. For example, causes Mediterranean spotted fever, a life-threatening disease for humans, whereas is associated with limited or no pathogenicity to humans. However, the molecular basis responsible for the different pathogenicity attributes are still not understood. Read More

IDCases 2019 21;15:e00528. Epub 2019 Mar 21.

Department of Infectious Diseases, Fattouma Bourguiba Hospital, Monastir, Tunisia.

Mediterranean spotted fever is a generally benign disease but with the potential of serious manifestations. We report a case of Mediterranean spotted fever in a 56-year-old woman, with pet dog exposure, who presented with a septic shock pattern. Based on clinical symptoms, history, and laboratory results, the diagnosis of Mediterranean spotted fever was suspected and the outcome was favorable with doxycycline treatment. Read More

Eur J Clin Microbiol Infect Dis 2019 Jul 11;38(7):1333-1337. Epub 2019 Apr 11.

Infectious Diseases Unit, Internal Medicine Service, Hospital de Terrassa (Consorci Sanitari de Terrassa), Ctra. Torrebonica s/n, 08227, Terrassa, Spain.

The objective of this study is to evaluate the characteristics and outcome of elderly patients with Mediterranean spotted fever (MSF). This study was a prospective observational cohort study of all adult cases with confirmed MSF treated in a teaching hospital (1984-2015) to compare the characteristics of elderly patients (> 65 years) with younger adults. We identified 263 adult patients with MSF, and 53 (20. Read More

Zoonoses Public Health 2019 08 11;66(5):458-469. Epub 2019 Mar 11.

Division of Public Health Surveillance and Response, Division of the National Health Laboratory Service, National Institute for Communicable Diseases, Johannesburg, South Africa.

Endemic zoonoses, such as Q fever and spotted fever group (SFG) rickettsiosis, are prevalent in South Africa, yet often undiagnosed. In this study, we reviewed the demographics and animal exposure history of patients presenting with acute febrile illness to community health clinics in Mpumalanga Province to identify trends and risk factors associated with exposure to Coxiella burnetii, the causative agent of Q fever, and infection by SFG Rickettsia spp. Clinical and serological data and questionnaires elucidating exposure to animals and their products were obtained from 141 acutely febrile patients between 2012 and 2016. Read More

Genes (Basel) 2019 03 8;10(3). Epub 2019 Mar 8.

Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA.

Mediterranean spotted fever develops from an infection with , an obligate intracellular, Gram-negative, endotheliotropic, and tick-transmitted bacterial pathogen, and is an acute, febrile illness that can progress to life-threatening complications if not diagnosed and treated early with effective antibiotics. Despite significant morbidity and mortality, little is known about changes in gene expression that determine the host responses during in vivo infection. We have investigated the transcriptional landscape of host lungs as a prominently affected organ system in an established murine model of infection by RNA-sequencing. Read More

Ticks Tick Borne Dis 2019 04 13;10(3):606-613. Epub 2019 Feb 13.

EA7310, Laboratoire de Virologie, Université de Corse-Inserm, Corte, France. Electronic address:

Although livestock farming (sheep, goats, pigs, and cattle) is an important economic activity in Corsica, a French Mediterranean island, knowledge about the tick fauna and microorganisms carried by them remains scarce. This study aimed to investigate the presence and perform molecular characterization of Anaplasmataceae, Rickettsia spp., and Borrelia burgdorferi sensu lato (sl) in tick species collected in Corsica. Read More

J Fr Ophtalmol 2019 Feb 22;42(2):e47-e50. Epub 2019 Jan 22.

Service d'ophtalmologie, hôpital Militaire d'Instruction Mohamed V, 10010 Rabat, Maroc.