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Boutonneuse fever (also called Mediterranean Spotted Fever) is a fever as a result of a Rickettsial infection caused by the bacterium Rickettsia connorii and transmitted by the dog tick Riphicephalus sanguineus. Boutonneuse fever is endemic in many countries surrounding the Mediterranean Sea. After the incubation period of around 7 days, the disease begins abruptly with chills, high fevers, muscular and articular pains, severe headache and photophobia. In the place of the bite forms a black crust (tache noire) Around the 4th day of the illness an exanthem appears, first macular and then maculopapular and sometimes petechial. The diagnosis is made with serologic methods, either the classic Weill Felix test (aglutination of Proteus OX strains ), either ELISA or immunofluorescence assays. The illness is treated with chloramphenicol or doxycycline.
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