Article in Japanese

Two cases of Japanese spotted fever in children

Eri MATSUTANI^1）,Masumi SETO^1）, Mitsuhiro MIYASHITA^2）,Toshiko YOSHIDA^1）, Kyoko MORIMOTO^1）

Japanese spotted fever is a Rickettsia infection transmitted by ticks carrying Rickettsia japonica. Since the risks of contacting ticks in the mountains and during farm work are considerable, it is said that Japanese spotted fever is mainly contracted by elderly people aged over 60 years old. However, there have been cases involving children. We encountered a pseudo-case of a 7-year-old boy (case 1) and a definitive case of an 8-year-old girl (case 2). Fever, erythema and puncture, which are the three main signs of Japanese spotted fever, were observed in both cases, with no awareness of tick bites at follow up. Case 1 and Case 2 had a history of travelling to Mie and Wakayama, respectively, of which both are endemic areas of Japanese spotted fever. Therefore, the disease was suspected from the clinical course, and successfully treated with tetracycline antibiotics. In recent years, Japanese spotted fever has been increasing steadily. It is suggested that the number of pediatric cases may increase in the future, due to the increase in outdoor activities during the COVID-19 pandemic. Although the prognosis is generally good, it may become more severe because of delayed treatment, and so it is extremely important to administer an appropriate antibacterial drug at the early stage.

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1）Department of Pediatrics, Saiseikai Senri Hospital
2）Department of Pediatrics, Osaka city university Hospital

Key words	Japanese spotted fever, Rickettsia japonica, ticks, eschar, tetracycline
Received	February 1, 2022
Accepted	April 27, 2022

34 (2)：123─130,2022