HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Colomba, C. Articles by Titone, L. Search for Related Content PubMed PubMed Citation Articles by Colomba, C. Articles by Titone, L. Agricola Articles by Colomba, C. Articles by Titone, L.

Atrial fibrillation in Mediterranean spotted fever

¹ Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Via del Vespro 129, 90127 Palermo, Italy

² Dipartimento di Patologie Emergenti, Clinica delle Malattie Infettive, Azienda Ospedaliera Universitaria Policlinico ‘Paolo Giaccone’, Via del Vespro 129, 90127 Palermo, Italy

Correspondence
Laura Saporito
laura.sapo{at}tin.it

Received March 25, 2008
Accepted July 2, 2008

Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii and characterized by fever, maculo-papular rash and a black eschar at the site of the tick bite (‘tache noir’). We describe the case of a 58-year-old man affected by MSF who developed atrial fibrillation. The patient presented himself to the hospital after 7 days of fever, malaise and severe headache. Cardiac auscultation revealed a chaotic heart rhythm and an electrocardiogram confirmed atrial fibrillation with a fast ventricular response. Diagnosis of MSF was made after the appearance of a maculo-papular skin rash, and treatment with oral doxycycline was started. An immunofluorescence antibody test confirmed R. conorii infection. The patient recovered after 7 days of treatment. Cardiac arrhythmia is a rare complication of MSF. Inflammation may play a role in the pathogenesis of atrial fibrillation. R. conorii is an intracellular bacterium which could trigger atrial fibrillation. Our patient was previously healthy and had no reported history of cardiac disease. This suggests that heart function should be monitored in MSF patients even in the absence of underlying risk factors.

Abbreviations: ALT, alanine aminotransferase; AST, aminotransferase; ECG, electrocardiogram; MSF, Mediterranean spotted fever; PLT, platelet.