Sandfly fever-a "neglected" disease

• Published in: Hautarzt Vol. 69; no. 11; p. 928
• Main Authors: Stahn, B, Sudeck, H, Frickmann, H, Krüger, A, Burchard, H G, Wiemer, D
• Format: Journal Article
• Language: German
• Published: Germany 01.11.2018
• Subjects: Animals; Antibodies, Viral; Diagnosis, Differential; Exanthema; Female; Humans; Middle Aged; Phlebotomus Fever - diagnosis; Phlebotomus Fever - immunology; Phlebovirus - immunology; Phlebovirus - isolation & purification; Travel; Vector-borne diseases; Mediterranean; Meningitis; Pappataci fever; Phlebovirus
• ISSN: 1432-1173
• DOI: 10.1007/s00105-018-4251-1

A 45-year-old woman presented at the outpatient department of a center for tropical diseases with fever, diarrhea, headache, myalgia, malaise, and an itchy papular rash. She had been on holiday with her family for 11 days in a mountain village in northern Cyprus. The place was infested with a lot of small, stinging flies or mosquitoes. She and her family became sick after they returned home. The physical examination was normal apart from the rash on the inside of the extremities. Significantly elevated transaminases and a slightly increased C‑reactive protein level were found in the blood examination. Considering the country of travel, the report of the "stinging flies" and the clinical presentation, sandfly fever was also taken into account as a differential diagnosis for the hepatitis. Antibodies to the sandfly fever Sicilian virus (SFSV) were detected. They showed the typical dynamics during the course of the illness and thus "pappataci fever" was diagnosed. The case report and a short review of up-to-date literature is meant encourage consideration of phlebovirus infection as a possible differential diagnosis in travelers or refugees suffering from severe febrile hepatitis and rash or aseptic viral meningitis after their stay in the Mediterranean area.