In order to investigate the
prevalence of rickettsioses in febrile
exanthemas in eastern Algeria, we conducted a prospective serological analysis of all patients presenting with this clinical picture at the
Infectious Diseases Department in the Batna
Hospital from January 2000 to September 2006. One hundred and eight
adult patients were included in the study, 46% of whom younger than 25 years, and 72.5% were admitted from May to September. Patients were tested for
antibodies to
Rickettsia conorii conorii,
R. conorii israelensis,
R. aeschlimannii, R.
felis,
R. sibirica mongolitimonae,
R. africae, R.
massiliae,
R. typhi, and
R. prowazekii using microimmunofluorescence and
Western blot as confirmation procedure. Both methods confirmed the
diagnosis of
Mediterranean spotted fever in 5 patients (4.6%), flea
spotted fever in 2 patients (1.9%), and
R. aeschlimannii infection in 2 patients (1.9%). In addition, 4 patients were diagnosed as having
murine typhus (3.7%) and one with epidemic
typhus (0.9%). To the best of our knowledge, this is the first report of
R. felis infection and
R. aeschlimannii infection in Algeria. In conclusion, at least 5 different kinds of
rickettsiosis coexist in eastern Algeria and, being responsible for 13% of cases of febrile exanthemas, should be considered among major causes of this clinical picture in this
area. In addition, we emphasize the high incidence of typhus group rickettioses, including
epidemic typhus, in this area.
