[Clinical and epidemiological study of spotted fever group rickettsiosis in Albacete, Spain]

Abstract

Introduction: The aim of this study was to describe the clinical and epidemiological features of spotted fever group rickettsiosis acquired in the province of Albacete, Spain.

Methods: We retrospectively reviewed the clinical records of patients with a diagnosis of spotted fever group rickettsiosis and positive serologic results between 1997 and 2003. Criteria for inclusion were as follows: 1) seroconversion in IgG to Rickettsia conorii by indirect immunofluorescence, or 2) a single titer of 160 dollars with two or three of the following symptoms: fever, eschar, or rash.

Results: There were 41 cases in the study period. Mean age was 58 years (range: 14-84). Thirty-seven (90%) patients were 40 or more years old (RR: 10,1; 95% CI: 4,3-24,0). Twenty-five (63%) patients were of rural origin (RR: 3,5; 95% CI: 1,8-6,5). Thirty-six (88%) patients had regular or recent contact with the rural milieu or with animals. Forty patients had fever and 38 (93%) had one or two eschars. There were 32 cases of Mediterranean spotted fever, 2 cases with symptoms consistent with DEBONEL/TIBOLA, and 7 atypical cases with eschar and no rash.

Conclusion: Spotted fever group rickettsiosis was mainly found in adults in contact with the rural milieu or with animals. Age over 40 years old and residence in a rural area were risk factors. Mediterranean spotted fever was the most common syndrome.