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The differential diagnosis of Rickettsia prowazeki infection

Vanya, Melinda; Hajdu, Edit; Szucs, Zoltan; Szili, Karoly

Reviews in Medical Microbiology:
doi: 10.1097/MRM.0000000000000084

Introduction: We describe a rare case of Rickettsia prowazeki infection in male prisoners.

Objective: Our aim was to demonstrate a case of R. prowazeki infection in male prisoners presenting fever, dermatitis, and significant weight loss.

Case: We report the cases of male prisoners, aged 46, who developed progressive dermatitis, fever, and weight loss. Due to dermatitis and 38.4°C fever, we transferred the prisoners to the Department of Dermatology and Allergology, University of Szeged. The examination of the antigen test was negative for Plasmodium vivax, and biopsy was performed to exclude the vasculitis. For the potentially autoimmune cause of disease choloquine, antihistamine, methyl-prednisolone treatment was ordered. The dermaticological symptoms had progressed; therefore, we sent the patients to the Department of Infectology of Szeged and St Laszlo Hospital for further diagnosis.

The serological tests were positive for R. prowazeki. Following 10-day course of doxycycline treatment, the patients displayed a significant clinical improvement.

Conclusion: According to our knowledge, this is the first study to report the case of R. prowazeki in Central Europe.

Author Information

aStrict and Medium Regime Prison of Szeged

bDepartment of Public Health, Semmelweis University

cDepartment of Dermatology and Allergology, Albert Szent-Gyorgyi Clinical Centre, University of Szeged

dDepartment of Infectology, Albert Szent-Gyorgyi Clinical Centre, University of Szeged, Szeged, Hungary

eMediteam Zrt.

Correspondence to Melinda Vanya, MD, 13 Mars square Szeged, H-6725 Szeged, Hungary. E-mail:

Received 10 February, 2016

Revised 1 April, 2016

Accepted 17 June, 2016

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