The RT-PCR techniques developed appear to be sensitive, specific, and fast and could be helpful to detect those mycoses. However, it is also essential that physicians consider histoplasmosis and PCM in individuals coming from endemic areas and that they perform differential diagnosis. We are grateful to the Spanish National Health Hospitals listed below which have contributed by sending samples and data on their patients: Hospital Carlos III (Madrid), Hospital Clinico San Carlos (Madrid), Hospital Comarcal de Orihuela-Vega Baja (Orihuela, Alicante), Hospital Donostia (San Sebastian), Hospital General de Asturias (Oviedo), Hospital General de Lanzarote (Lanzarote), Hospital General Universitario Gregorio
Marañón (Madrid), Hospital General La Mancha Centro (Alcazar C59 wnt concentration de San Juan, Ciudad Real), Hospital General Universitario Morales Meseguer, Hospital de Hellín (Hellín, Albacete), Hospital Marina Baixa (Villajoyosa, Alicante), Hospital do Meixoeiro (Vigo, Pontevedra), Hospital Mutua de Terrassa (Terrassa, Barcelona), Hospital Universitario Carlos Haya (Málaga), Hospital Universitario Clinic de Barcelona (Barcelona), Hospital Universitario Doce de Octubre (Madrid), Hospital Universitari La Fe de Valencia (Valencia), Hospital Universitario Miguel Servet (Zaragoza), selleck screening library Hospital Universitario de Mostoles (Mostoles, Madrid), Hospital Universitario Principe de Asturias (Alcala de Henares, Madrid), Hospital Universitario Ramon y Cajal (Madrid), Hospital Universitario
Son Dureta (Mallorca), Hospital Universitario
Morin Hydrate Virgen de la Arrixaca (Murcia), Hospital Universitario Virgen de la Macarena (Sevilla), Hospital Vall d’Hebron (Barcelona), Hospital Virgen del Camino (Pamplona), and Hospital Virgen de la Salud (Toledo). L. B.-M. has a research contract from REIPI (Red Española de Investigación en Patología Infecciosa, Project MPY 1022/07_1) The authors state that they have no conflicts of interest to declare. “
“Background. Mediterranean spotted fever (MSF) is a tick-borne infection caused by Rickettsia conorii conorii mainly endemic in the Mediterranean Basin. Although usually considered as a benign disease, severe forms of MSF have been sporadically reported. Methods. We report on three patients who developed severe MSF complications after a stay in Morocco. Literature was reviewed to assess the frequency and pattern of MSF complications in the largest reported case series in endemic countries. Results. Each of our three patients diagnosed with MSF presented with a different complicated course: one with meningoencephalitis, one with lung embolism and one with septic shock and multi organ failure. In published series, rate of complications (defined as severe organ involvement) ranged from 1% to 20%. However, study designs and settings were highly variable and did not allow for relevant comparisons. Meningoencephalitis and shock with multi organ failure were the most frequently observed complications. Mortality of severe course was up to 20% in some series.