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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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RICKETTSIAL MENINGITIS: A RARE PRESENTATION

Inês Salva1, Rita de Sousa2, Catarina Gouveia3

1 – Departamento de Pediatria, Hospital de Dona Estefânia
2 – Instituto Nacional de Saúde Dr. Ricardo Jorge
3 – Unidade de Infecciologia Pediátrica, Hospital de Dona Estefânia

Publicação integral no British Medical Journal Case Reports, 2014, doi: 10.1136/bcr-2013-203283

Rickettsial infections are common in southern Europe and the most frequent and lethal type is Mediterranean spotted fever, caused by Rickettsia conorii. The disease is usually characterised by the classical triad of fever, eschar and rash and is generally a mild disease in children. Complications including neurological involvement are rarely described. We report an unusual case of meningitis in an 18 year-old male, presenting during summer with fever and persistent headache. The cerebrospinal fluid analysis revealed increased cellularity (107 cells/μL), hypoglycorrhachia (50% of glycemia) and hyperproteinorrhachia (284 mg/dL). Rickettsial infection was confirmed by serology and the patient was treated with doxycycline, with a favourable outcome. The patient’s pet squirrel and/or associated vectors might be implicated in the transmission of Rickettsia spp. This case underlines the importance of a high clinical suspicion and the benefits of early empirical treatment when facing compatible epidemiological

Palavras Chave: meningites, Rickettsia, atypical.