Abstract
Mediterranean spotted fever (MSF) was first described in 1910. Twenty years later, it was recognized as a rickettsial disease transmitted by the brown dog tick. In contrast to Rocky Mountain spotted fever (RMSF), MSF was thought to be a benign disease; however, the first severe case that resulted in death was reported in France in the 1980s. We have noted important changes in the epidemiology of MSF in the last 10 years, with emergence and reemergence of MSF in several countries. Advanced molecular tools have allowed Rickettsia conorii conorii to be classified as a subspecies of R. conorii. New clinical features, such as multiple eschars, have been recently reported. Moreover, MSF has become more severe than RMSF; the mortality rate was as high as 32% in Portugal in 1997. Whether Rhipicephalus sanguineus is the only vector and reservoir for R. conorii conorii is a question not yet answered.
Highlights
Mediterranean spotted fever (MSF) was first described in 1910
All rickettsioses with spotted fever group (SFG) antibodies were considered to have MSF in countries where this disease was endemic
In some other countries of the Mediterranean basin, such as Italy and Portugal, incidence of MSF has substantially increased in the past 10 years. Another point is that MSF was considered for 70 years a benign disease when compared with Rocky Mountain spotted fever (RMSF)
Summary
Mediterranean spotted fever (MSF) was first described in 1910 Twenty years later, it was recognized as a rickettsial disease transmitted by the brown dog tick. In contrast to Rocky Mountain spotted fever (RMSF), MSF was thought to be a benign disease; the first severe case that resulted in death was reported in France in the 1980s. Mediterranean spotted fever (MSF) is a tick-borne disease caused by Rickettsia conorii. In some other countries of the Mediterranean basin, such as Italy and Portugal, incidence of MSF has substantially increased in the past 10 years. Another point is that MSF was considered for 70 years a benign disease when compared with Rocky Mountain spotted fever (RMSF).
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