765. Epidemiological And Clinical Features Of Rickettsiosis

Abstract

Background: Rickettsiosis is a common tick-borne disease in tropical regions. The treatment is usually delivered in front of high index of suspicion, since the diagnosis confirmation might be delayed. We aimed to study the epidemiological and clinical features of rickettsiosis in our region. Methods: We conducted a retrospective study including all patients hospitalized in the infectious diseases and pediatric department for confirmed rickettsiosis between 1995 and 2017. The diagnosis was confirmed by serological tests (seroconversion) or a positive polymerase chain reaction assays for Rickettsia. Results: There were 424 patients among whom 232 (54.7%) were male. The mean age was 39 ±18 years. There were 62 children aged ≤18 years (14.6%). During six months period, from May to October, 360 patients were diagnosed with the disease (84.9%). In total, 334 patients had a close contact with animals (78.7%). The revealing symptoms were fever (100%), arthralgia (77.6%), cephalalgia (72.4%) and vomiting (44.8%). Physical examination showed maculopapular skin rash in 350 cases (82.5%), inoculation eschar in 105 cases (24.8%) and meningeal syndrome in 43 cases (10.1%). There were 43 cases (10.1%) of meningitis, 6 cases of meningoencephalitis (1.4%) and 5 cases of myocarditis (1.2%). Laboratory investigations revealed liver cytolysis (60%) and thrombocytopenia (57.5%). Doxycycline was used in 288 cases (68%), fluoroquinolones in 113 cases (26.6%) and macrolide in 23 cases (5.4%). The mean duration of antibiotics was 8 ±4 days. The disease evolution was favourable in 418 cases (98.6%). Four patients (1%) were dead and 2 patients (0.4%) were transferred to intensive care unit. Conclusion: Rickettsiosis is not a rare disease. Careful clinical and laboratory investigations guide the diagnosis process, which is confirmed with serological tests.