RICKETSIOSIS
IN CHILDREN OF NORTHWESTERN GREECE (EPIRUS)
Getsi V, Tsirka A, Kotsias S, Rita S, Haloulou
S, Gologani A
Department of Pediatrics, General Hospital;
Hatzikosta, Ioannina, Greece
Introduction: In recent years, an
increase of the diagnosed cases of ricketsiosis in children has been
reported in many areas of the world. In addition, new stems of the organism
have been recognized with the help of DNA apping. The causative agents in
Greece are R. Conorii, R. Typhi, Coxiella Burnetti and Ehrlichia
Chaffensis.
Aim of the study: In the present study we wanted to report the
causative agent of the disease, the types of arthropod carriers, the
epidemiological characteristics and clinical symptoms of the sick children.
Material: Over a period of three
years (Oct -96, Sept - 99) five children were diagnosed and treated. They
were all males ranging from 16 months to 9.5 years of age (mean value: 5,11
years). The diagnosis was based on clinical observations and the increase
of the titre of specific antibodies. The detection was made by Indirect
Fluorescent Antibody test IFA.
Results: Two children (case 1,2)
had Q fever from Coxiella Burnetti and an increase titre of antibodies. A
tick was removed from their bodies. The other two (cases 3,4) had
Mediterranean spotted fever from R.Conorii. They did not report any contact
with animals or tick. The youngest patient (case 5) had Rocky Mountain
spotted fever from R.Rickettsii, he had come into contact with sheep,
goats, and dogs who had flees and he developed meningitis. All children had
fever (390C-400C) for 4-12 days and maculopapular exanthem. 3/5 had
arthralgias and myalgias and 4/5 had lemphadenopathy and hepatomegaly. All
patients were treated with Chloramphenicole. The outcome of the disease was
excellent.
Conclusions: The diversity of
clinical manifestations of ricketsiosis and the special epidemiological
behavior need very good knowledge on the part of the pediatrician. A very
good collaboration between doctors and Health Care Services is needed for
their prevention.