Familial cases of boutonneuse fever

Intrafamilial outbreak of Mediterranean spotted fever

The existence of intrafamilial outbreaks of spotted-fever group rickettsioses has seldom been reported, and their true incidence is not known. We here report the occurrence of Mediterranean spotted fever (MSF) in three members of a family: a boy, his grandmother and his grandfather. The infection resolved uneventfully in the boy, and followed a more protracted course in the two older patients, who suffered complications including drowsiness, clotting defects and acute renal failure. This finding highlights the importance of conditioning factors such as age and associated illnesses in the prognosis of infection due to Rickettsia conorii, and suggests that strict surveillance of individuals at risk of infection is necessary for prompt recognition of the onset of the illness and initiation of antibiotic treatment without delay.