First isolation of Rickettsia conorii from humans in the Trakya (European) region of Turkey

In the Trakya region of Turkey, located in the European part of the country, presumptive cases of Mediterranean spotted fever have been diagnosed and treated every summer since the beginning of the 1990s. The aim of this prospective study was to isolate and identify the rickettsial strains from blood samples of 11 patients and from skin biopsies of 10 of these 11 patients with the diagnosis of spotted fever in the Trakya region of Turkey in 2003. Immunofluorescence assay was performed with acute-phase and convalescent-phase serum samples of 11 patients. All patients had significant antibody titers against spotted fever group rickettsiae. Rickettsia conorii was isolated from the skin biopsies of three of ten patients and was also demonstrated by polymerase chain reaction in skin biopsies of nine of ten patients. In southeastern Europe, the Balkan Peninsula (including the Trakya region of Turkey) is an area where arthropods are endemic and where new arthropod-borne infections can be detected.