Mediterranean spotted fever in the Trakya region of Turkey

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dc.authoridRolain, Jean-Marc/0000-0002-2402-4467
dc.authoridParola, Philippe/0000-0002-1061-1927
dc.authorwosidRolain, Jean-Marc/Y-3788-2019
dc.authorwosidParola, Philippe/AAY-4346-2021
dc.contributor.authorKuloglu, Figen
dc.contributor.authorRolain, Jean Marc
dc.contributor.authorAkata, Filiz
dc.contributor.authorEroglu, Cafer
dc.contributor.authorCelik, Aygul Dogan
dc.contributor.authorParola, Philippe
dc.date.accessioned2024-06-12T11:08:13Z
dc.date.available2024-06-12T11:08:13Z
dc.date.issued2012
dc.departmentTrakya Üniversitesien_US
dc.description.abstractMediterranean spotted fever (MSF) is caused by a tick-borne pathogen, Rickettsia conorii subsp. conorii, belonging to the spotted fever group (SFG) rickettsiae. The aim of the present study was to evaluate the cases with confirmed diagnosis of MSF from 2003 to 2009 in the Trakya region of Turkey. Patients with high fever, maculopapular rash (involving the palms or soles) and/or a black inoculation eschar at the site of the tick bite (tache noire) were included in the study. Before doxycycline treatment, skin biopsy specimens, preferably from the eschar or from the maculopapular rash, were obtained for DNA extraction. Immunofluorescence assay (IFA) was performed to detect IgM and IgG antibodies against R. conorii in acute and convalescent sera. Afterwards, a standard PCR reaction using primers suitable for hybridisation within the conserved region of genes coding for outer membrane protein A (ompA) and citrate synthase (gItA) and DNA sequencing were performed. There were 128 patients with confirmed MSF diagnosis. Using IFA, seroconversion or a fourfold or greater rise in titre was observed in 97(77%) patients, whereas a single high titre was demonstrated in 16(12.7%) patients. According to PCR analysis, 77(72.6%) of 106 biopsy samples showed positive results. Of these, 58(73%) of 79 biopsy specimens were from the eschar and 19 (70%) of 27 specimens were from the maculopapular rash. No significant difference was found between the rate of positive skin biopsies taken from the eschar and the maculopapular rash. DNA sequence analysis was performed to all PCR-positive cases, and R. conorii conorii (type strain: Mal ish, ATCC VR-613) was detected in each of them. MSF is prevalent, but has been underdiagnosed and underreported so far in Turkey. It is a potentially severe and even fatal disease resembling viral haemorrhagic fevers that has to be included in the differential diagnosis of febrile illness associated with thrombocytopenia, even in the absence of an eschar or a tick bite. While IFA allows for retrospective diagnosis in MSF, advanced molecular techniques provide the rapid detection of rickettsia in all skin samples, including eschar and maculopapular rash. (C) 2012 Elsevier GmbH. All rights reserved.en_US
dc.description.sponsorshipScientific and Technological Research Council of Turkey (TUBITAK) [104S290]en_US
dc.description.sponsorshipWe thank our faculty members and research assistants who have contributed to this project for 7 years. This work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) (Project No. 104S290).en_US
dc.identifier.doi10.1016/j.ttbdis.2012.10.030
dc.identifier.endpage303en_US
dc.identifier.issn1877-959X
dc.identifier.issn1877-9603
dc.identifier.issue5-6en_US
dc.identifier.pmid23168048en_US
dc.identifier.scopus2-s2.0-84870446597en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage297en_US
dc.identifier.urihttps://doi.org/10.1016/j.ttbdis.2012.10.030
dc.identifier.urihttps://hdl.handle.net/20.500.14551/22352
dc.identifier.volume3en_US
dc.identifier.wosWOS:000314081000007en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Gmbhen_US
dc.relation.ispartofTicks And Tick-Borne Diseasesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectMediterranean Spotted Feveren_US
dc.subjectTurkeyen_US
dc.subjectEuropean Regionen_US
dc.subjectRickettsia-Conoriien_US
dc.subjectFeaturesen_US
dc.subjectDiseasesen_US
dc.subjectOlden_US
dc.titleMediterranean spotted fever in the Trakya region of Turkeyen_US
dc.typeArticleen_US

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