Abstract：
Mediterranean spotted fever (MSF) is a tick-borne acute endemic infectious disease caused by Rickettsia conorii. While MSF may progress asymptomatically, it may lead to clinical pictures like severe hemorrhagic fever. In this article, we are presenting an MSF case with signs of high fever, headache, nausea, weakness and generalized maculopapular rash. The diagnosis of the female patient who had a history of contact with a tick-infested dog was confirmed with her clinical and laboratory data. The clinical and laboratory findings of the patient who was given doxycycline by 200 mg/day for 7 days were improved in a short time. Rickettsia conorii serology by indirect immunofluorescence assay method confirmed the diagnosis of MSF. In cases of severe sepsis accompanied by high fever and generalized maculopapular rash where the source of the infection cannot be determined in the short term, carefully questioning exposure to ticks by considering the existing geographical, seasonal and endemic environmental factors may be life-saving in terms of early diagnosis and treatment of MSF, which may become fatal even in the absence of eschars (tache noire). The symptomatology of hemorrhagic fever associated with Rickettsia conorii may be confused with that of sepsis in clinical practice.
摘要：
地中海斑疹热（MSF）是由立克次体引起的tick传播的急性地方性传染病。虽然无国界医生可能进展缓慢，这可能会导致严重出血热等临床图片。在这篇文章中,我们提出一个无国界医生有高烧迹象的案例，头痛,恶心,无力和泛发性斑丘疹。具有与蜱出没的狗接触史的女性患者的诊断通过她的临床和实验室数据得到证实。给予多西环素200mg/天7天的患者的临床和实验室检查结果在短时间内得到改善。conorii立克次体血清学通过间接免疫荧光分析方法证实了MSF的诊断。在严重败血症伴有高热和全身性斑丘疹的情况下，短期内无法确定感染源，通过考虑现有的地理位置，仔细质疑对蜱的接触，就无国界医生的早期诊断和治疗而言，季节性和地方性环境因素可能会挽救生命，这可能会成为致命的，即使在没有eschars（tachenoire）。在临床实践中，与立克次体相关的出血热的症状可能与败血症的症状相混淆。
