Mediterranean Spotted Fever in Adults Aged Over 60 Years

Nowadays the distribution and course of Mediterranean spotted fever is characterized by an increasing number of severe cases and its complications worldwide. Age-dependent changes and processes of ageing influence to a different extent upon the course of the infectious diseases. The authors examined the course of the Mediterranean spotted fever in adults aged over 60 years. The study covered 90 elderly patients treated in the First Clinic of Infectious Diseases at St. Marina University Hospital of Varna during the period from 2000 till 2003. Of them, 58 were females (64,4%) and 32 males (35,6%). Their hospital stay was 8,5 0,12 days long (p<0,05) while that of 30 control persons aged between 18 and 57 years was 7 0,32 days long. Clinical patterns and biochemical parameters were followed-up. The diagnosis was serologically confirmed in 28,8% of the patients. Some 79,2% of the elderly patients presented with accompanying diseases in contrast to 46,8% of the controls (p<0,001). Cardiovascular and cerebrovascular diseases occurred most commonly followed by chronic obstructive pulmonary disease, pneumopathies, diabetes mellitus, etc. One and the same patient often presented with several accompanying diseases. Contact with dogs was reported in 64,9% but tick biting - in 22% of the cases. The etiological treatment included tetracyclines and chlornitromycin or quinolones of third generation as an alternative. Pathogenetic and symptomatic therapy was also administered along with treatment of the accompanying diseases. The authors recommended the hospitalization of the elderly patients with Mediterranean spotted fever and the antibiotic therapy with chlornitromycin or quinolones of third generation of the severe forms. General practitioners' attention should be paid on the risk in such patients with delayed diagnosis and treatment.