Akademik Veri Yönetim Sistemi
40th ANNUAL MEETING OF THE EUROPEAN SOCIETY FOR PAEDIATRIC INFECTIOUS DISEASES (ESPID), ATİNA, Yunanistan, 09 Mayıs 2022, cilt.1, sa.231, ss.231
Rickettsia species are gram-negative intracellular, small pleomorphic coccobacilli. Rickettsia conorii in the spotted fever group was reported to cause mediterranean spotted fever in Europe, especially in mediterranean countries including Turkey. The major vectors of Rickettsia species are ticks, in some species fleas or mites.
A 17-year-old male patient presented with complaints of severe headache, diffuse myalgia, and fever for 1 week. he had headache about 1 month but get severe in last week, and he works in forest and complain about insect bites. In examination, he has suspicious stiff neck, muscle tenderness, and petechial exanthems just bilateral forearm. In first laboratory; leucocyte 6500/mm3 , trombocyte 122000/mm3, CRP 148 mg/L, ALT 163 U/L, ferritin 1089 ng/mL, fibrinogen 494 ng/dL, D-dimer 15,9 mg/L, eritrocyte sedimentation rate 20 mm/hour. In progress headache was continued and he complained for blurred vision. Enlarged perioptical CSF areas in MRI and grade 1 papilledema was detected. CSF sampling was done for fever and headache. CSF findings was normal but CSF pressure was measured as 34 cmH2O. Acetazolamide treatment was given for increased intracranial pressure. For insect bites, fever, petechial exanthem, miyalgia, serology was studied for Crimean-Congo hemorrhagic fever and Rickettsial pathogens. Rickettsia conori IgM ELISA was detected as 1/192 and doxycycline treatment was given for 10 days. For severe myalgia, non-steroidal anti-inflammatory drugs was started. Blood and CSF cultere was negative. In progress patients’ symptoms regressed.
In pandemic era , patients considered mostly for common diseases, but detailed anamnesis should be taken. We present a case which is presented in similar findings with MIS-C and other infectious diseases but anamnesis lead us to specific serology tests.