Boutonneuse fever

Boutonneuse fever
Typical eschar and spots on the leg of a patient with Boutonneuse fever
Classification and external resources
Specialty	Infectious disease
ICD-10	A77.1
ICD-9-CM	082.1
DiseasesDB	31780
MeSH	D001907
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Boutonneuse fever (also called Mediterranean spotted fever, fièvre boutonneuse, Kenya tick typhus, Indian tick typhus, Marseilles fever, or African tick-bite 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 can be seen in many places around the world, although it is endemic in countries surrounding the Mediterranean Sea. This disease was first described in Tunisia in 1910 by Conor and Bruch and was named boutonneuse (French for "spotty") due to its papular skin rash characteristics.

After an incubation period 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 ulcerous crust (tache noire). Around the fourth day of the illness, a widespread rash appears, first macular and then maculopapular and sometimes petechial.

The diagnosis is made with serologic methods, either the classic Weil-Felix test (agglutination of Proteus OX strains ), ELISA, or immunofluorescence assays in the bioptic material of the primary lesion.

The illness can be treated with tetracyclines (doxycycline is the preferred treatment), chloramphenicol, macrolides or fluoroquinolones.

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