Table 2. Clinical characteristics of 5 case-patients with Israeli spotted fever, Sharon District, Israel*.
| Characteristic | Case-patient 1 | Case-patient 2 | Case-patient 3 | Case-patient 4 | Case-patient 5 |
|---|---|---|---|---|---|
| Age, y/sex |
75/F |
51/F |
38/ M |
48/M |
45/M |
| Concurrent condition |
Hypertension |
Mental retardation, diabetes mellitus |
None |
Alcoholism, HCV carrier, IVDU |
Nephrolithiasis, psoriasis |
| Signs/symptoms at hospitalization | |||||
| Fever | Yes | Yes | Yes | Yes | Yes |
| Rash | Purpura fulminans | Maculopapular, then purpura fulminans | Maculopapular | Maculopapular | Maculopapular |
| Day of rash from disease onset | 6 | 6 | 4 | 4 | 3 |
| Hypotension | Yes | Yes | No | No | No |
| Multiorgan failure | Yes | Yes | No | No | No |
| Eschar | No | No | No | No | No |
| Headache | No | Unknown | Yes | No | No |
| Confusion | No | No | No | No | No |
| Myalgia |
Yes |
Unknown |
Yes |
No |
No |
| Epidemiologic factor | |||||
| Animal exposure | Dog | Unknown | Dog | None | Dog |
| Tick exposure |
No |
No |
No |
No |
No |
| Serologic result, day/result | |||||
| First sample | 9/nonreactive | 6/IgM titer >100, IgG titer borderline† | 6/nonreactive | 6/nonreactive | 5/nonreactive |
| Second sample |
19/IgM titer nonreactive, IgG titer 1:800† |
NR |
NR |
NR |
19/IgM titer >1:100, IgG titer 1:1,600† |
| PCR result, whole blood/doxycycline treatment day | NR | +/3 | NR | NR | –/5 |
| PCR result, skin biopsy specimen/doxycycline treatment day |
+/4 |
+/3 |
+/4 |
+/3 |
–/3 |
| Doxycycline treatment | |||||
| Day of illness | 6 | 5 | 5 | 5 | 4 |
| Day of hospitalization |
0 |
2 |
0 |
1 |
0 |
| Length of hospitalization, d |
14 |
20 |
7 |
4 |
8 |
| Outcome | Died | Died | Survived | Survived | Survived |
*HCV, hepatitis C virus; IVDU, intravenous drug use; NR, not relevant/not obtained; +, positive; –, negative. †Results from the Israeli reference laboratory for rickettsial diseases.