[Meningoencephalitis caused by Rickettsia conorii in a young infant].

BACKGROUND

Mediterranean spotted fever is an infectious disease due to Rickettsia conori, endemic in the Mediterranean basin. It is usually considered to be a benign disease; however, severe systemic manifestations have been reported in which neurological involvement occurs. These complications are rare in children.

METHODS

We report a case of a 14-month-old boy, who was hospitalized for meningoencephalitis after seven days of high fever and maculopapular rash. On clinical observation there were generalized maculopapular elements and an inoculation eschar tache noire at the right ear. The diagnosis of Mediterranean spotted fever was established by epidemiological and clinical features and was confirmed by elevated IgM antibody titres against R. conorii by indirect immunofluorescence assay. Despite treatment with macrolides and corticosteroids, severe neurological sequelae have remained including decreased vision and epileptic seizures.

CONCLUSIONS

The physiopathology of Mediterranean spotted fever includes diffuse vasculitis with endothelial injury. Early diagnosis and specific antibiotic treatment may reduce the risk of complications.