ABSTRACT
BACKGROUND Mediterranean spotted fever (MSF) was described by Conor and Bruch in Tunisia in 1910 (1) and was soon reported in other regions around the Mediterranean basin-the Black Sea littoral, India, the Middle East, and southern Africa. The disease was thereafter also known as “boutonneuse fever” because of a papular rather than macular rash. The typical inoculation eschar was described in 1925 in Marseille by Boinet and Pieri (2). In the early 1930s, the brown dog tick Rhipicephalus sanguineus was recognized as a vector in Europe (3), and a spotted-fever group rickettsia was shown to be the causative agent; this organism was named Rickettsia conorii in honor of the work of Conor.
