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BMC Infect Dis 2022 Apr 1;22(1):320. Epub 2022 Apr 1.

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

Background: Mediterranean spotted fever (MSF) is a zoonotic and vector-borne disease caused by Rickettsia conorii. We report a case (36 year-old-woman) of MSF caused by Rickettsia conorii from Iran.

Case Presentation: In September 2019, the patient was admitted to the hospital in Kerman province with flu-like symptoms and maculopapular lesions. Read More

Comp Immunol Microbiol Infect Dis 2022 Mar 22;85:101798. Epub 2022 Mar 22.

Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran. Electronic address:

Ticks are considered as the reservoirs for pathogenic Rickettsia for humans and domestic animals. Recently, clinical cases of rickettsiosis have been reported from Iran and its surrounding countries. This study was aimed at investigating the prevalence of Rickettsia spp. Read More

Comp Immunol Microbiol Infect Dis 2022 Apr 13;83:101769. Epub 2022 Feb 13.

Facultad de Ciencias de la Vida, Universidad Andres Bello, República 440, Santiago, Chile; Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Miguel Servet 177, Zaragoza 50013, Spain; Fundación ARAID, Avda. de Ranillas, Zaragoza 50018, Spain. Electronic address:

Antibodies against Spotted Fever Group (SFG) Rickettsia and Coxiella burnetii, investigated through indirect antibody immunofluorescence tests, were detected in serum samples from 3.1% and 0% of 358 rural dogs, respectively, and in none of 32 wild foxes tested. SFG Rickettsia seropositive dogs were only detected in the Mountain Desert (8%) and the Steppe-Mediterranean (9%) regions. Read More

Trop Med Infect Dis 2022 Feb 19;7(2). Epub 2022 Feb 19.

CNC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal.

The order Rickettsiales includes species that cause a range of human diseases such as human granulocytic anaplasmosis (), human monocytic ehrlichiosis (), scrub typhus (), epidemic typhus (), murine typhus (), Mediterranean spotted fever (), or Rocky Mountain spotted fever (). These diseases are gaining a new momentum given their resurgence patterns and geographical expansion due to the overall rise in temperature and other human-induced pressure, thereby remaining a major public health concern. As obligate intracellular bacteria, Rickettsiales are characterized by their small genome sizes due to reductive evolution. Read More

Eur J Case Rep Intern Med 2022 17;9(1):003073. Epub 2022 Jan 17.

Internal Medicine Department, Hospital de Cascais Dr. José de Almeida, Alcabideche, Portugal.

spp. human infection is endemic in Portugal in the form of Mediterranean spotted fever caused by subsp. and Israeli spotted fever (ISF) caused by subsp. Read More

Int J Infect Dis 2022 Apr 30;117:15-17. Epub 2022 Jan 30.

Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France. Electronic address:

Mediterranean spotted fever (MSF) caused by the bacterium Rickettsia conorii is one of the oldest known tick-borne diseases. It is transmitted by the brown dog tick Rhipicephalus sanguineus and occurs mainly in the Mediterranean area. MSF usually presents with a skin rash, high fever, and characteristic eschar at the site of the tick bite. Read More

Emerg Infect Dis 2022 02;28(2):485-488

A fatal case of Mediterranean spotted fever associated with septic shock was reported in a 61-year-old man living in a village in southeastern Iran. The patient had a history of tick bite a few days before symptom onset. Phylogenetic analysis confirmed infection by Rickettsia conorii subspecies israelensis. Read More

Trop Med Infect Dis 2022 Jan 14;7(1). Epub 2022 Jan 14.

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy.

Background: Motivated by a case finding of Mediterranean spotted fever (MSF) associated with atypical pneumonia and pleural effusion in which was identified by molecular methods in the pleural fluid, we wanted to summarize the clinical presentations of rickettsiosis in Italy by systematic research and to make a systematic review of all the global cases of rickettsiosis associated with pleural effusion.

Methods: For the literature search, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. We chose to select only the studies published in last 25 years and confirmed both with serological and molecular assays. Read More

Rev Med Interne 2022 04 14;43(4):265-266. Epub 2022 Jan 14.

Médecine interne et polyvalente post-urgences, CHU de Nîmes, Nîmes, France. Electronic address:

mBio 2021 12 7;12(6):e0305921. Epub 2021 Dec 7.

CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.

Rickettsiae are obligate intracellular Gram-negative bacteria transmitted by arthropod vectors. Despite their reduced genomes, the function(s) of the majority of rickettsial proteins remains to be uncovered. APRc is a highly conserved retropepsin-type protease, suggested to act as a modulator of other rickettsial surface proteins with a role in adhesion/invasion. Read More

Enferm Infecc Microbiol Clin (Engl Ed) 2022 01 31;40(1):44-45. Epub 2021 Oct 31.

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

Trop Med Infect Dis 2021 Sep 24;6(4). Epub 2021 Sep 24.

Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece.

Mediterranean spotted fever (MSF) is an emerging tick-borne rickettsiosis of the spotted fever group (SFG), endemic in the Mediterranean basin. By virtue of technological innovations in molecular genetics, it has been determined that the causative agent of MSF is subspecies . The arthropod vector of this bacterium is the brown dog tick . Read More

Emerg Infect Dis 2021 10;27(10):2691-2694

We describe 3 similar cases of rickettsial disease that occurred after tick bites in a mountainous rural area of Shandong Province, China. Next-generation sequencing indicated the etiologic agent of 1 patient was Rickettsia conorii subspecies indica. This agent may be more widely distributed across China than previously thought. Read More

Infection 2022 Feb 9;50(1):269-272. Epub 2021 Sep 9.

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy.

Background: The most common Italian rickettsiosis is Mediterranean Spotted Fever (MSF). MSF is commonly associated with a symptom triad consisting of fever, cutaneous rash, and inoculation eschar. The rash is usually maculopapular but, especially in severe presentations, may be petechial. Read More

Curr Trop Med Rep 2021 Jun 16;8(2):104-111. Epub 2021 Feb 16.

Investigador SNI Senacyt Panamá, Clinical Research Department, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá.

Purpose Of Review: Travel medicine practitioners often are confronted with returning travelers with dermatologic disorders that could be of infectious causes or inflammatory or allergic. Some dermatologic processes are the result of exposure to insects or acquired due to environmental exposures. There is a broad range of dermatosis of infectious and non-infectious etiologies that clinicians need to consider in the differential diagnosis of dermatosis in travelers. Read More

Pan Afr Med J 2021 19;38:377. Epub 2021 Apr 19.

Department of Internal Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia.

Infections are an important cause of morbidity and mortality in Systemic Lupus Erythematosus (SLE). Mediterranean spotted fever (MSF) is a tick-borne disease caused by Rickettsia conorii. This infection is endemic in Tunisia with summer seasonality. Read More

Emerg Infect Dis 2021 08;27(8):2117-2126

In a multicenter, nationwide, retrospective study of patients hospitalized with spotted fever group rickettsiosis in Israel during 2010-2019, we identified 42 cases, of which 36 were autochthonous. The most prevalent species was the Rickettsia conorii Israeli tick typhus strain (n = 33, 79%); infection with this species necessitated intensive care for 52% of patients and was associated with a 30% fatality rate. A history of tick bite was rare, found for only 5% of patients; eschar was found in 12%; and leukocytosis was more common than leukopenia. Read More

Semergen 2021 May-Jun;47(4):e31-e32. Epub 2020 Oct 24.

Medicina Familiar y Comunitaria, Centro de Salud Valencia Alfahuir. Departamento Valencia Clínico Malvarrosa, Valencia, España.

IDCases 2021 27;24:e01136. Epub 2021 Apr 27.

Internal Medicine in Centro Hospitalar e Universitário de Coimbra, Portugal.

Mediterranean spotted fever (MSF) is an emerging zoonosis caused by . The MSF typically presents with a triad of fever, generalized cutaneous rash and inoculation eschar, but its clinical spectrum may range from a mild febrile illness to a potentially life-threatening condition, being central nervous system involvement highly rare. We report the clinical case of a 63-year-old male patient with MSF complicated by acute encephalitis and multi-organic failure. Read More

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 29;30(4):369-375. Epub 2021 Mar 29.

Department of Anatomy, Histology and Embryology, Faculty of Medicine, Medical University, Plovdiv, Bulgaria.

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

Parasite Immunol 2021 05 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 (Engl Ed) 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

Med Clin (Barc) 2021 11 6;157(10):498-499. Epub 2021 Jan 6.

Servicio de Medicina Intensiva, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

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