Abstract
Introduction:Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii. Most cases follow a benign course, with a case fatality rate of 3–7 % among hospitalized patients. Complications are described mainly in adult patients and include hepatic, renal, neurological and cardiac impairment. Among cardiac complications, pericarditis, myocarditis and heart rhythm disorders are uncommon complications in MSF and only a few cases have been reported in the literature.Case Presentation: We describe a new case of acute myocarditis complicating MSF in an immunocompetent adult patient without risk factors for severe MSF.Conclusion:Myocarditis is an uncommon but severe complication of MSF. Clinicians should be aware of a possible cardiac involvement in patients with MSF. Close monitoring and an aggressive approach are essential to reduce mortality rates of MSF.
Highlights
Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii
We describe a new case of acute myocarditis complicating MSF in an immunocompetent adult patient without risk factors for severe MSF
Cardiac impairment is a rare complication of severe Rickettsia spp. infection
Summary
Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii. We describe the case of a 54-year-old man who was admitted to the infectious diseases clinic of the University Hospital of Palermo, Sicily, Italy in August 2014 because of MSF complicated by sepsis-induced multi-organ failure and myocarditis. He presented with fever for a few days. An echocardiogram showed a dilated ventricle, reduced ejection fraction (35 %), and diffuse moderate hypokinesis. The cranial computed tomography (CT) scan was normal, the chest CT scan showed signs of severe emphysema, patchy interstitial infiltrate in the right ã 2016 The Authors Published by Microbiology Society. At the six-month follow-up the patient was in good clinical condition
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