A Case of Rickettsiosis in a non-Endemic Region

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dc.contributor.authorSalduz, Ekrem
dc.contributor.authorErdemci, Leyla
dc.contributor.authorAltunisik Toplu, Sibel
dc.date.accessioned2026-04-04T13:30:41Z
dc.date.available2026-04-04T13:30:41Z
dc.date.issued2025
dc.departmentİnönü Üniversitesi
dc.description.abstractMediterranean spotted fever (MSF) is an acute, febrile rickettsiosis caused by Rickettsia conorii, which is endemic in Africa, Mediterranean countries, and Turkiye, with most reported cases originating from the Marmara region. This case presents a patient from a non-endemic region who was hospitalized with a preliminary diagnosis of Crimean-Congo Hemorrhagic Fever (CCHF) after experiencing a tick bite, followed by fever, rash, and headache, and was subsequently diagnosed with MSF. The patient initially presented to the emergency department with a tick attached to the distal posterolateral area of the left thigh. The tick was removed, and the patient was discharged. Approximately ten days later, they returned with joint pain, headache, weakness, and fever. Initially suspected of CCHF, the examination revealed widespread maculopapular rashes and petechiae, along with a hyperemic lesion at the tick attachment site. Laboratory tests ruled out CCHF, with negative PCR and IgM results. Due to persistent symptoms, R. conorii IgM and IgG tests were ordered, and empirical treatment with doxycycline (2 x 100 mg/day PO) was initiated. A fever response was observed by the second day of Rickettsia treatment, with indirect immunofluorescence antibody tests confirming R. conorii IgM (1/384) and IgG (1/1280) positivity. After completing a full ten-day course of doxycycline, the patient was discharged. This case underscores the importance of considering rickettsiosis in the differential diagnosis of fever and rash following tick exposure, even in non-endemic regions, and aims to raise awareness through its publication in the literature.
dc.identifier.doi10.5578/flora.2025021243
dc.identifier.endpage217
dc.identifier.issn1300-932X
dc.identifier.issn2602-2842
dc.identifier.issue2
dc.identifier.orcid0000-0002-2915-4666
dc.identifier.startpage213
dc.identifier.trdizinid1318146
dc.identifier.urihttps://doi.org/10.5578/flora.2025021243
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay/1318146
dc.identifier.urihttps://hdl.handle.net/11616/108308
dc.identifier.volume30
dc.identifier.wosWOS:001519661600011
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakTR-Dizin
dc.language.isotr
dc.publisherBilimsel Tip Yayinevi
dc.relation.ispartofFlora Infeksiyon Hastaliklari Ve Klinik Mikrobiyoloji Dergisi
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectRickettsia
dc.subjectFever
dc.subjectTick
dc.subjectRash
dc.titleA Case of Rickettsiosis in a non-Endemic Region
dc.typeArticle

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