The boutonneuse fever is also called Mediterranean tick typhus called and describes the transfer form and the original main geographical region of the bacterial disease. After an incubation period of several days, infected people develop fever, rashes, general impairment of well-being, and muscle and joint pain. Basically, boutonneuse fever is only rarely a life-threatening infectious disease.

What is boutonneuse fever?

According to phonecations, boutonneuse fever is one of the infectious diseases caused by the bacteria of the rickettsial strain. After the bite of a tick infected with rickettsiae, a black, button-like focus of inflammation forms at the site of the bite.

The derivation of the name comes from this typical feature, since “Bouton” is the French word for button. The ticks that transmit boutonneuse fever are mainly found in the Mediterranean region. Due to climate change and a northward direction of spread, Mediterranean tick spotted fever can now also be found in the cooler, northern parts of Europe.

The course of the disease is only in rare cases severe or even fatal. In most cases, an existing pre-existing illness or a weakened immune system must be present in order to cause such a severe course in Boutonneuse fever.

Causes

Boutonneuse fever infection is only caused by infected ticks. When a tick bites, the tick first bites into the skin and injures it. She draws blood in order to spit out the contents of her stomach towards the end of this exposure.

This gets into the wound. The rickettsiae are located in the stomach contents and are given the opportunity to pass from the tick host to humans. The rickettsiae cause an infection in the body that is in part similar to a flu. These include fatigue, fever, and body aches. What is noticeable in boutonneuse fever is the change in the skin directly around the bite site.

A rash with a dark patch on the skin can be seen. Mediterranean tick spotted fever is one of the milder fever infections that are transmitted by tick bites.

Symptoms, ailments & signs

In contrast to other tick-borne diseases, such as Lyme disease or meningoencephalitis, symptoms of an infection with rickettsiae appear a very short time after the insect bite if an infection has occurred. As a rule, those affected do not notice that they have boutonneuse fever, as the side effects usually resemble those of a flu-like infection.

About five to ten days after the tick bite, patients often feel exhausted and suffer from headaches. Usually there are also fever and joint pain or muscle pain. In sensitive patients, there is also a swelling of the lymph nodes, but usually only to the extent that it is not uncommon with colds.

If the course is more severe, there may be abdominal pain, nausea and vomiting, as well as red spots on the skin or a rash. Occasionally, patients also develop conjunctivitis. The few symptoms typical of the disease do not show up in every patient.

Often, however, small blue-black discolored ulcers develop at the puncture site. When the ulcers appear, there is almost always swelling of the lymph nodes and a reddish rash. The symptoms last between a few days and two weeks, depending on the severity of the course.

Diagnosis & course

To diagnose Boutonneuse spotted fever, the attending physician draws up a detailed anamnesis with a focus on tick bite events within the past five to seven days.

In addition, there is a visual diagnosis of the area around the bite site or, if Boutonneuse fever is suspected without a specific bite event, a detailed examination of the body for conspicuous areas. The exact determination of Boutonneuse fever can take place via a blood test and the creation of a bacterial culture. It is especially helpful if the tick that caused the bite is still there.

If left untreated, boutonneuse fever can resolve on its own after several days of illness. If the affected patients are weakened in their immune system, the course of the Mediterranean tick fever can intensify. Boutonneuse fever is fatal in a small percentage of those affected.

Complications

In contrast to other tick-borne diseases, such as Lyme disease or meningoencephalitis, symptoms of an infection with rickettsiae appear a very short time after the insect bite, if an infection has occurred. As a rule, those affected do not notice that they have boutonneuse fever, as the side effects usually resemble those of a flu-like infection.

About five to ten days after the tick bite, patients often feel exhausted and suffer from headaches. Usually there are also fever and joint pain or muscle pain. In sensitive patients, there is also a swelling of the lymph nodes, but usually only to the extent that it is not uncommon with colds.

If the course is more severe, there may be abdominal pain, nausea and vomiting, as well as red spots on the skin or a rash. Occasionally, patients also develop conjunctivitis. The few symptoms typical of the disease do not show up in every patient.

Often, however, small blue-black discolored ulcers develop at the puncture site. When the ulcers appear, there is almost always swelling of the lymph nodes and a reddish rash. The symptoms last between a few days and two weeks, depending on the severity of the course.

When should you go to the doctor?

With a tick bite you should always go to a doctor. Medical advice is indicated at the latest when the first symptoms of Boutonneuse fever appear. In particular, nausea and vomiting, fever, headache and skin rashes should be clarified immediately.

If a red stripe appears at the bite site, it can be assumed that there is an infection that must be treated immediately. A rapid diagnosis significantly improves the chances of success of a treatment and prevents serious complications and long-term damage.

However, slight reddening at the bite site does not always require treatment. If the inflammation resolves within a few days after the first visit to the doctor, no further examination is required. If the symptoms do not improve after a few days, further treatment steps must be initiated.

This is especially true if there are symptoms such as swelling of the lymph nodes or blackish-blue ulcers at the bite site. Conjunctivitis and muscle and joint pain are also clear warning signs of an infection with Boutonneuse fever and require an immediate doctor’s visit.

Treatment & Therapy

Boutonneuse fever can be cured in the majority of cases by administering antibiotics. Treatment should begin as soon as possible after the first symptoms appear. Doxycycline has proven itself in boutonneuse fever. Symptoms improve shortly after starting treatment with this active ingredient. If not, the diagnosis should be checked for boutonneuse fever.

Other tick bite infections show similar symptoms, but have a more serious course, so treatment with other antibiotics and a more precise diagnosis of the pathogen must be examined. For risk groups such as weakened people or allergy sufferers, an inpatient stay may be necessary because of Boutonneuse fever. High fever and persistent nausea and vomiting are major contributors to hospitalization.

This also applies if the kidneys are impaired or there are signs of meningitis in the course of the disease. Regardless of the severity of the Mediterranean tick spotted fever infection, patients should be provided with pain reliever and antipyretic medication to relieve symptoms.

Outlook & forecast

Boutonneuse fever is a bacterial disease that urgently requires medication and medical treatment. Only through professional treatment can the entire course of the disease be positively influenced.

Boutonneuse fever is transmitted by a tick bite, so there is usually always a bite where the tick may still be. If the tick is still in the wound, the animal should be removed by a doctor. Otherwise the wound could become infected and possibly even blood poisoning.

Affected people initially suffer from flu-like symptoms. There is aching limbs, headaches, a high temperature, nausea and vomiting. Around the existing bite site, the skin will become very dark in color. This discoloration will definitely occur even with medical treatment and medication. After four to five days, the individual symptoms will subside, provided the person concerned has a strong immune system.

Boutonneuse fever can also be overcome without any treatment. However, without such a treatment, a significantly more unpleasant course of the disease can be expected. Individual symptoms will increase considerably and thus make the entire course of the disease more difficult, so that affected persons with a treatment will have a much more positive prospect of a quick cure.

Prevention

Prevention of boutonneuse spotted fever is comprehensive tick prevention, as a vaccine is not available. This includes appropriate clothing in tick-infested areas. Dogs that are often the target of ticks should be treated with appropriate tick products in order to avoid the possibility of Boutonneuse fever in close proximity to people. If a tick is removed, it should be kept frozen until the Boutonneuse spotted fever incubation period has expired in order to make it easier to identify the pathogen.

Aftercare

In most cases, boutonneuse fever does not require any special follow-up care. The disease is easy to treat and not associated with any particular complications. The person affected should ensure that they take the medication regularly in order to limit the symptoms completely.

An inpatient stay is only necessary in rare cases. However, kidney function should be monitored during treatment in order to detect meningitis at an early stage. In the case of boutonneuse fever, the wound should also be well cared for and covered with a bandage in order to avoid inflammation or even blood poisoning.

The affected person needs a lot of rest and has to recover. Exercise or other physical exertion should generally be avoided. A healthy diet has a positive effect on the further course. In the event of illness, the patient should also refrain from alcohol and nicotine. Life expectancy is not negatively affected by Boutonneuse fever.

After the treatment, the affected person should protect himself particularly well from the ticks in the respective areas in order to avoid recurrence. The entire body should be examined for ticks, especially in tall grass or after a long period outside.

You can do that yourself

Boutonneuse fever is a serious bacterial infection. Pure self-therapy is strongly discouraged.

The best form of prevention for boutonneuse fever is to avoid the cause, which is brown dog tick bites. Those who go on vacation in risk areas should avoid tall grass and low bushes and shrubs when outdoors and hiking. After being outdoors, the entire body and clothing should be examined for ticks. Long pants and long-sleeved outerwear help detect ticks before they have bitten.

However, the primary host of the brown dog tick is actually dogs. The four-legged friend should therefore not be brought into a risk area. If this cannot be avoided, the animal must be checked for ticks, preferably several times a day. Close physical contact with the dog, especially sleeping together in a bed, should be avoided at all costs during this time. In addition, special collars can keep parasites away.

It is also important to keep your immune system intact. Sufficient sleep, a vitamin-rich plant-based diet and avoiding too much sugar, alcohol and nicotine all contribute to this. In naturopathy, the immune system is also strengthened by taking ascorbic acid (vitamin C) and extracts from the red coneflower.

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