ASSESSMENT OF THE ORGAN SYSTEM INVOLVEMENT IN THE MALIGNANT FORMS OF SPOTTED FEVER RICKETTSIOSIS

Abstract

PURPOSE: Mediterranean spotted fever (MSF), a spotted fever rickettsiosis caused by Rickettsia conorii has become a significant health risk for suffering people and international travelers. The purpose of the study was to outline the prognostic factors of the fatal outcome in the diseased patients. MATERIALS AND METHODS: In this report, we present the organ system involvement in 55 patients (19 fatalities and 36 survivors) with malignant forms of the disease. RESULTS: Based on our data, the most frequently involved organ systems of malignant cases were: central nervous system 100%, liver 92.72%, kidneys 60%, lungs 58.18%, myocardium 30.9%, and gastrointestinal tract 23.63%. The conducted histopathological investigations revealed lethal complications: encephalitis, brain edema, acute respiratory distress syndrome, non-cardiogenic lung swelling, acute myocarditis, gastrointestinal bleeding, hemorrhagic-necrotizing pancreatitis and acute renal failure. CONCLUSION: The main prediction factors for mortality in malignant MSF patients were the vital organ system complications. In the past, overlooked as a serious disease, at present it is known that MSF was wrongly considered a benign condition.