Mediterranean spotted fever with multiorgan involvement

Kimberly Davis*, Ahmad Ahmado, Clare E. Warrell, Louise O. Downs, Jenna Furneaux, Karthiga Sithamparanathan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


A previously well man in his 50s returned to the UK after a trip to the Mediterranean. The day after returning he developed malaise, fevers, rigors and severe headache. He was hospitalised with sepsis, multiorgan involvement, a maculopapular rash and an eschar on each hip. Serology was positive for Rickettsia spp (spotted fever group) with a rise in titre from 1:64 to 1:1024 eight days later. Blood and tissue PCR were also positive for Rickettsia spp. He had cardiac, pulmonary, renal, ocular and neurological involvement. He completed a 14-day course of doxycycline and recovered well. This is a case of likely Mediterranean spotted fever (MSF) caused by Rickettsia conorii, which is endemic to the Mediterranean basin. We highlight the need for awareness and early treatment to prevent severe complications. This case is also the first to describe Purtscher-like retinopathy in the context of likely MSF.

Original languageEnglish
Article numbere249426
JournalBMJ Case Reports
Issue number12
Publication statusPublished - 21 Dec 2022
Externally publishedYes

Bibliographical note

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  • Travel medicine
  • Tropical medicine (infectious disease)


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