Mediterranean Spotted Fever in Children in the Pazardjik Region, South Bulgaria

Abstract

The objective of the present study was to analyze the clinical pattern of contemporary Mediterranean spotted fever in children and to compare it with the clinical pattern in adults. The research involved 257 children. The more common symptoms in children were severe onset, fever, rash, "tache noire," swelling of lymph nodes and enlarged liver or spleen.

Mediterranean Spotted Fever in Children: Study of a Portuguese Endemic Region

“…Flu-like symptoms are also common, and in our study, myalgia and abdominal pain were the most frequently described. In two large series of MSF, 5,7 rash was present in 94.5% -100% of patients and, in our sample, it was found in all cases as described by Pishmisheva et al in South Bulgaria. 7 Only 7 (21.9%) of our cases presented with rash in the first day of fever, with the majority (62.5%) appearing on the second and third days of fever.…”

“…1,5 All patients presented with fever and a rash, similarly to what is frequently described in the literature. 6,7 Headache, classically reported as a symptom, occurred in only 25% of our patients, possibly reflecting under-reporting due to the frequent administration of antipyretics/analgesics for fever. Flu-like symptoms are also common, and in our study, myalgia and abdominal pain were the most frequently described.…”

The diversity of tick-borne bacteria and parasites in ticks collected from the Strandja Nature Park in south-eastern Bulgaria

“…Until today, studies in Bulgaria were mostly focused on Lyme disease in humans, sheep, cows and dogs [ 4 , 22 , 23 ]. Most studies from Bulgaria on tick-borne pathogens are serological surveys in humans, cattle and dogs [ 2 , 22 – 24 ] and there are only a few studies investigating ticks for tick-borne pathogens [ 5 , 22 , 25 ]. Further, these studies examined only a small sample size of ticks ( n = 94–299) [ 4 , 6 , 7 , 12 ].…”

“…The Mediterranean spotted fever (MSF), which is mainly caused by R. conorii , may have a far more severe outcome. MSF is endemic in some regions in Bulgaria, and severe cases have been reported [ 2 , 3 ]. Ixodes ricinus , Dermacentor reticulatus and Rhipicephalus spp.…”

Liver and Bile Duct Infections

“…The disease is found in Mediterranean countries between the months of June and September and classically presents with fever, maculopapular rash, and a black eschar at the bite site (known as "tache noire," or black spot in French). 360 As is the case with Q fever, boutonneuse fever may be associated with the hemophagocytic syndrome. 337 Hepatic involvement shows Kupffer cell swelling and increased sinusoidal cellularity.…”