eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2022-09-20 10 9 235 238 10.12691/ajmcr-10-9-6 AJMCR20221096 article Oadi N. Shrateh oadi.shrateh@students.alquds.edu 1 Raneen R. Sweity 1 Rabee S. Adwan 2 Faculty of Medicine, Al-Quds University, Jerusalem, Palestine Infectious Diseases Unit, Makassed Charitable Society Hospital, East Jerusalem, Palestine Introduction: Mediterranean spotted fever (MSF) is an emerging and zoonotic disease caused by Rickettsia conorii. The main arthropod vector of this bacterium is Rhipicephalus sanguineus, also called ˇ°brown dog tickˇ±. We report a 3-month-old infant affected by MSF as the first reported case of the condition in Palestine. Clinical report: in July 2022, a previously healthy 3-month-old child was admitted to the hospital due to fever, diffuse maculopapular rash and a black spot on his leg. Laboratory assessment revealed thrombocytopenia, hypoalbuminemia, and elevated liver enzymes. Polymerase chain reaction (PCR) testing was positive for Rickettsia Conorii and a diagnosis MSF was ascertained. The patient was completely recovered with doxycycline treatment. Conclusion: Mediterranean spotted fever (MSF) is endemic in Africa, India, Europe and Mediterranean countries; including Palestine. In this case study, we affirm the significance of suspecting MSF in patients presenting with fever and rash even in those who stay in their homes apart from environments with high tick-exposure possibility. http://pubs.sciepub.com/ajmcr/10/9/6/ajmcr-10-9-6.pdf mediterranean spotted fever Palestine Rickettsia conorii Rhipicephalus sanguineus doxycycline