Hemorrhagic-Necrotizing Pancreatitis – An Unusual Complication of Mediterranean Spotted Fever
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Mediterranean spotted fever (MSF) or Boutonneuse fever is a tick-borne endemic disease caused by Rickettsia conorii. It is characterized by fever, maculo-papular rash and an eschar at the site of tick bite, named black spot or tache noire. MSF has usually mild or moderate course, and has long been considered a benign disease. However, very severe “malignant” forms have been observed with involvement of vital organ systems, serious complications and fatal outcome. Acute pancreatitis is a rare complication of MSF, and hemorrhagic-necrotizing pancreatitis is an unusual consequence of the disease. We report two lethal cases of malignant MSF, presenting with hemorrhagic-necrotizing involvement of the pancreatic gland. An immunofluorescence antibody test confirmed Rickettsia conorii infection. The clinical diagnosis of pancreatitis was defined only in one of the reported patients due to abdominal tenderness and elevated levels of serum amylase. In both cases the diagnosis had histological confirmation at autopsy. Rickettsial vasculitis may play a role in the pathogenesis of pancreatic destruction. This report is an attempt to warn patients and medical staff for this fatal pancreatic involvement in the process of rickettsial inflammation.
Authors and Affiliations
Ivan Baltadzhiev, Nedialka Popivanova, Zaprian Zaprianov
Keywords
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- EP ID EP591714
- DOI 10.9790/0853-160301109112
- Views 50
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