A rare complication of rickettsiosis: thrombophlebitis

Makram Koubaa, Amal Chakroun, Fatma Hammami, Wiem Feki, khaoula Rekik, Chakib Marrakchi, Zaineb Mnif, Fatma Smaoui, Mounir Ben Jemaa



AIM: Rickettsiosis is an endemic anthropozoonosis, especially around the Mediterranean. Although it is reputed to be benign, it can have several complications including vascular which can be serious and sometimes fatal. We report the case of a patient who had rickettsiosis complicated by deep vein thrombosis.

CASE REPORT: A 77-year-old patient, without any particular pathological history, was admitted for acute fever and confusion. On clinical examination, he had altered consciousness and a maculopapular rash. Rickettsial serology was in favor of a recent infection with Rickettsiae conorii. The patient was treated with ciprofloxacin and preventive anticoagulation. During hospitalization, he developed a rapid atrial fibrillation at 140 cycle per minute with inflammatory signs of the left lower limb, which was edematous. Venous Doppler ultrasound showed the presence of left iliofemoral thrombophlebitis. He received curative antigoagutation therapy but the outcome was fatal after a respiratory distress related to pulmonary embolism. CONCLUSION: The vascular complications of rickettsiosis are due to endothelitis caused by these bacteria. The location of these vascular damage conditions the patient's vital prognosis. It is impotant to diagnosis of these complications for better therapeutic management.

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