Boutonneuse fever

Boutonneuse fever (also called Mediterranean spotted fever, fièvre boutonneuse, or Marseilles fever) is a fever as a result of a Rickettsial infection caused by the bacterium Rickettsia conorii and transmitted by the dog tick Riphicephalus sanguineus. Boutonneuse fever is endemic in many countries surrounding the Mediterranean Sea.

Presentation
After the incubation period of around 7 days, the disease begins abruptly with chills, high fevers, muscular and articular pains, severe headache and photophobia. In the place of the bite forms a black crust (tache noire) Around the 4th day of the illness an exanthem appears, first macular and then maculopapular and sometimes petechial.

Diagnosis
The diagnosis is made with serologic methods, either the classic Weil Felix test (agglutination of Proteus OX strains ), either ELISA or immunofluorescence assays.

Treatment
The illness is treated with chloramphenicol or doxycycline.