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Nodular fever is a disease transmitted by dog ticks and is widespread in the Mediterranean. The ailment is caused by Rickettsia conori, which is transmitted by dog ticks. Initially, ulceration appears at the site of the bite, followed by enlargement of the lymph nodes.
What is nodular fever?
Nodular fever, also known as Mediterranean spotted fever, is an infectious disease caused by bacteria Rickettsia conorii, living intracellularly. The vector of the infection is ticks that live mainly on dogs. As in other rickettsial infections, human infection occurs either by the tick’s suckling and blood collection, or by rubbing infected material from a damaged tick or its faeces into damaged skin. A skin necrosis is formed at the site of the bite, resembling a black spot in its appearance. Nodular fever is widespread in southern Europe, the Middle and Middle East, especially in the Mediterranean, Black Sea and Caspian Sea, as well as in Africa and India. In Poland, nodular fever usually occurs as a disease brought by tourists / migrants from endemic countries of this disease. The highest number of cases is recorded in the period from June to September.
Types of nodular fever:
- lumpy fever of the Rocky Mountains in the United States,
- Mediterranean nodular fever in Europe,
- typhoid fever (Australia),
- São Paulo fever in Brazil
- Oriental nodular fever in Asia,
- nodular fever in Tasmania.
Symptoms of nodular fever
The incubation period of spotted fever is: from 5 to 7 days. It has a mild or medium-severe course, lasting from a few to several days. Initially, a black spot appears at the site of the bite – the primary ulcer with surrounding redness. Then there is an enlargement of the surrounding lymph nodes, accompanied by headaches and muscle and joint pain. On day 4-5 of the disease, there is a generalized maculopapular rash, also affecting the hands and feet, lasting about 7 days. High temperature is also characteristic. Symptoms usually last for about three weeks.
Diagnosis and treatment of nodular fever
In the diagnosis of nodular fever, a medical history is necessary, as it is impossible to make a diagnosis based solely on clinical symptoms. On physical examination, your doctor may find typical skin changes, a high fever, and enlarged lymph nodes. On the other hand, patients with complications are diagnosed with disturbances of consciousness, enlargement of the liver and spleen, or auscultation changes in the heart and lungs. In addition, laboratory blood tests are performed to detect antibodies against Rickettsia conorii. Thanks to an early diagnosis, the chances of recovery are much greater.
The treatment uses antibiotics that are active against atypical bacteria. They should be taken for about 7 days, and when complications occur – antibiotic therapy is extended to 2 weeks. Although nodular fever is rather mild in most patients, there are cases of complications. They are most common in the elderly, immunocompromised patients and alcoholics.
The most common complications of the disease are:
- multi-organ failure,
- stroke,
- respiratory failure,
- acute kidney failure,
- gastrointestinal bleeding
- deep vein thrombosis,
- sometimes inflammation of the joints and the nervous system.
After treatment, patients should be monitored regularly by a doctor until symptoms have completely resolved.
How to prevent getting sick?
First of all, avoid contact with ticks and animals carrying ticks (e.g. dogs). In addition, after a trip to an area where they occur or after contact with a dog, carefully inspect the skin and always remove any ticks. Also, remember to wear long-sleeved and leggy garments when going for a walk in the woods.
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