Abstract
Mediterranean Spotted Fever (MSF), associating fever, maculo-papular rash and inoculation eschar is the oldest known tick-borne disease (first case reported in Tunisia, 1910). MSF is caused by the bacterium Rickettsia conorii, transmitted by the brown dog tick Rhipicephalus sanguineus mainly in the Mediterranean area. The diagnosis of this infection has long been fastidious, and based on serology, because R.conorii is an intracellular bacterium. Nowadays, real time PCR techniques can be performed on an eschar swab and have considerably improved the diagnostic tools for clinicians. The diagnosis must be done quickly because the disease can be severe in about 5% of cases and the prognosis depends on the precocious treatment with doxycycline. The prevention of MSF relies on the prevention of tick bites in endemic areas, mainly in southern Europe and Maghreb.
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