mediterranean exanthematous fever

Boutonneuse fever

Boutonneuse fever (also called Mediterranean spotted fever, fièvre boutonneuse, or Marseilles fever) is a fever as a result of a Rickettsial infection caused by the bacterium Rickettsia conorii and transmitted by the dog tick Rhipicephalus sanguineus. Boutonneuse fever is endemic in many countries surrounding the Mediterranean Sea. The French word boutonneuse means pimply.


After an incubation period of around seven days, the disease manifests abruptly with chills, high fevers, muscular and articular pains, severe headache and photophobia. The location of the bite forms a black crust (tache noire). Around the fourth day of the illness an exanthem (widespread rash) appears, first macular and then maculopapular and sometimes petechial.


The diagnosis is made with serologic methods, either the classic Weill Felix test (agglutination of Proteus OX strains ), either ELISA or immunofluorescence assays.


The illness is treated with chloramphenicol or doxycycline.

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