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2023

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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EARLY DIAGNOSIS OF SEVERE ISRAELI SPOTTED FEVER

S.Bota1, R. De Sousa2, M.L. Ventura3, C. Gouveia1

Pediatric Infecciology Unit, Hospital Dona Estefânia, Lisbon, Portugal1
Pediatric Intensive Care Unit, Hospital Dona Estefânia, Lisbon, Portugal3
Center for Vectors and Infectious Diseases Research, National Institute of Health Dr Ricardo Jorge, Águas de Moura, Portugal2

1. INTRODUCTION
Israeli spotted fever (ISF) is caused by Rickettsia conorii Israeli spotted fever strain. In Portugal, it was first described for the first time in 1999.

2. CASE REPORT

  • July 2013
  • ♀ 12 years-­old
  • Rural area in the south of Portugal
  • Daily contact with dogs
  • No history of tick bites or eschar

3. DISCUSSION
Severe cases of Israeli spotted fever have been increasingly reported, mostly in adults. In children, it is usually a mild disease. The mechanism by which ISF strain causes more severe illness remains to be determined. The patient’s epidemiology and typical rash
facilitated the early clinical diagnosis and prompt empirical treatment, which was probably crucial. The absence of an inoculation eschar should not delay the diagnosis.