Boutonneuse fever

The boutonneuse fever is transmitted by ticks and occurs mainly in the mediterranean. This is how you can protect yourself.

Boutonneuse fever

The Boutonneuse fever (Mediterranean Tick Sting Fever) is a bacterial infectious disease transmitted by ticks. It is found, especially in the Mediterranean, in close contact with infected rodents or dogs. Typical symptoms are high fever and a rash. After antibiotic therapy, Boutonneuse fever generally heals without consequences. Here you read everything important about the Boutonneuse fever.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in doctor's letters or on incapacity certificates. A77

Product Overview

Boutonneuse fever

  • description

  • symptoms

  • Causes and risk factors

  • Examinations and diagnosis

  • treatment

  • Disease course and prognosis

Boutonneuse fever: description

The Boutonneuse fever is also known as Mediterranean fever, as it is widespread throughout the Mediterranean. It is an infectious disease caused by the bacterium Rickettsia conorii. Diseases caused by these or other rickettsia are also referred to as rickettsiosis after their discoverer Howard Tayler Ricket. The bacteria are all spread by ticks, fleas, mites or lice.

The Boutonneuse fever is transmitted by ticks and is one of the most common tick bite fever in southern Europe. In Portugal, for example, 10 out of every 100,000 people suffer from Boutonneuse fever each year. Not infrequently vacationers from Central Europe are also affected. Individual cases have also been recorded in Africa and the Black Sea.

The term "Boutonneuse" comes from the French and can be translated as "spotty" or "button-like". It describes the blotchy skin conditions that Boutonneuse fever produces.

Boutonneuse fever: symptoms

The pathogen of Boutonneuse fever is transmitted by tick bites. After two to seven days, every second affected person develops a lentil-like skin lesion around the puncture site. This primary lesion may break in the middle and then be covered with brownish-black scab. Often, the lymph nodes are inflamed near the puncture site and enlarged palpable (lymphadenitis).

At the same time, sufferers develop the eponymous Boutonneuse fever: body temperature rises to over 39 degrees Celsius for about one to two weeks.

On the third to fifth day of illness, a coarse patch rash develops (maculopapular rash). Together with the fever, it disappears again without leaving dandruff, scars or other marks.

The typical symptoms of Boutonneuse fever are often accompanied by headache, joint pain and muscle aches.

Boutonneuse fever: complications

The infection with the pathogen of Boutonneuse fever activates the immune system in the body. The body's own inflammatory substances (cytokines) can be elevated in the blood and influence the coagulation system. For example, some people with Boutonneuse fever develop blood clots that can clog vessels and, for example, cause deep vein thrombosis.

Older people, alcoholics and people with diabetes (diabetes mellitus) are more likely to experience complications. In the case of Boutonneuse fever, encephalitis and meningitis with coma and convulsions were observed. In addition, partially inflame the blood vessels of the internal organs (vasculitis). Whenever an important organ is poorly perfused, its function is compromised. This can finally go so far that the Boutonneuse fever ends fatally.

Boutonneuse fever: causes and risk factors

The Boutonneuse fever is caused by the bacterium Rickettsia conorii. This bacterium lives as a parasite, especially in ticks, which in turn live in the coat of rodents or dogs. In the Mediterranean, up to 70 percent of dogs are infected with ticks. About every tenth tick carries rickettsia. If the dogs are brought to Germany, the rickettsia will arrive in our country. The ticks can be transmitted from the dogs to humans. Fortunately, this rarely happens because the ticks prefer dogs. But you can survive for years in apartments and cause again and again the Boutonneuse fever in humans.

Boutonneuse fever: examinations and diagnosis

The right contact person for Boutonneuse fever is a specialist in internal medicine with the additional name Infectiology. Even a tropical medicine specialist knows about this disease. At the typical symptoms of fever and rash, however, sufferers first seek out their family doctor. He too can initiate the necessary investigations. First, he could ask you the following questions.

  • Have you recently been outside Germany, especially in Mediterranean areas?
  • Did you have closer contact with rodents or dogs from these regions?
  • Are you aware of a tick-infestation of pets in your area?
  • Have you noticed a puncture site or a conspicuous area on the skin?
  • Do other people in your area have similar symptoms?
  • Do you have fever? If so, since when is it and how high is it?
  • Have you noticed any other symptoms?

Subsequently, the doctor will measure their body temperature and examine the entire skin. He scans the lymph node regions. If there is a suspicion of a Boutenneuse fever, the doctor will take a tissue sample from a conspicuous skin area and have it examined in the laboratory.

A blood test is also possible. However, it can only detect the pathogen group and not the exact type of bacteria and is therefore considered inaccurate. However, a blood sample can rule out other diseases with similar symptoms.

Boutonneuse fever: treatment

Boutonneuse fever is treated with the antibiotic doxycycline. Patients must take one tablet twice a day for two to seven days.

Pregnant women and children under the age of eight can develop dangerous side effects of doxycycline. You should therefore be treated with another antibiotic (azithromycin).

Boutonneuse fever: prophylaxis

So that it does not come to a Boutonneuse fever, you should protect yourself by certain measures from the infected ticks. Especially with close contact to possibly infected rodents and dogs in Mediterranean areas one should take precautions:

Wear closed-high-heeled shoes and long trousers that you put in stockings. As a result, ticks have no way to reach a free skin area on their feet or legs. Through the clothing through a transfer is not possible. Anti-tick sprays-sprayed on clothing or wrists-keeps ticks off. It is particularly important to carefully search his entire body for the insects after a trip to a tick area. Bright clothes make it easier to find the ticks.

Dogs should always wear a tick collar.

Boutonneuse fever: disease course and prognosis

In most cases, the Boutonneuse fever is mild. All disease symptoms resolve within about two weeks and leave no consequences. Especially if the disease is diagnosed in good time and treated with antibiotics, complications occur extremely rarely. Most likely to develop in the elderly, alcoholics and diabetics. It is easier for you to also affect the internal organs such as the brain. It ends in one to five percent of cases Boutonneuse fever deadly.


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