Abstract

Rickettsioses are considered as emerging or re-emerging arthropod-borne zoonosis. In addition, Meningeal syndromes are also among the most common reasons for consultation in infectious disease emergency. Our study aimed to identify Rickettsia spp in patients presenting with viral Meningeal Syndrome at the National Centre of Infectious Diseases in Algiers, El-HADI FLICI We collected 55 sera and 55 whole blood from patients with viral meningeal syndrome for Serologic tests using an indirect immunofluorescent antibody (IFA) assay for testing a panel of Rickettsial antigens and Extracted DNA was used in qPCR amplifications the gltA gene of Rickettsia species , at the Hospital-University Institute (IHU), Marseille-France. The indirect immunofluorescence assay (IFA) for Rickettsia spp returned positive results in seven sera (7/55, 12.72%). We diagnosed four cases of Spotted Mediterranean Fever (MSF) caused by R. conorii, two cases of Murine Typhus caused by R. typhi, and one case of Flea-borne Spotted Fever caused by R. felis. All the whole blood q PCR came back negative for the Rickettsial gene gltA, even in patients whose sera tested positive for any Rickettsial species using IFA. Concerning the spinal Tap, we reported in three patients positive for R. conorii, where cerebrospinal fluid was opalescent and mixed cellular profile on cytology. These findings suggest a possible co-infection with R. conorii in patients with meningeal syndrome.Thus, the serological findings coupled with the Meningeal syndrome, and the diverse clinical manifestations of both pathogens observed among these patients, suggest a possible overlap in clinical expression. These results highlight the importance of heightened awareness among infectious disease specialists, particularly when faced with confirmed cases of Meningeal Syndrome that may exhibit clinical similarities with Rickettsial diseases, especially in regions where hematophagous arthropod-borne zoonoses are prevalent.