People may use the term “Mediterranean fever” to refer to two different and unrelated medical conditions. The first is a genetic disorder known as familial Mediterranean fever, which is most commonly seen in populations around the Mediterranean. This term is also used to describe brucellosis, a bacterial infection that can be observed in many Mediterranean populations. While both conditions are associated with the Mediterranean region and both cause fevers, they are caused and treated very differently.
In the case of familial Mediterranean fever, the disease is inherited. It is a recessive, requiring people to inherit a copy of the defective gene from both parents in order to develop the disease, and it usually onsets in childhood, with people experiencing episodes in their youth. Diagnosis depends on the symptoms, disclosure of family history, and medical tests to rule out other potential causes.
People with familial Mediterranean fever experience periodic attacks of high fever. In around three quarters of patients, symptoms like joint, stomach, and chest pain develop during attacks. The episodes normally run their course without intervention but some patients benefit from analgesic medications to address the pain, as well as anti-inflammatory drugs to reduce the inflammation associated with the disease.
A drug known as cholchicine is used in the treatment of familial Mediterranean fever. This drug can act as a prophylactic if taken in advance of an attack to prevent the onset of another round of fever and other symptoms. Patients who learn to recognize the warning signs can take a peremptory dose to shut down the inflammation before it starts.
Brucellosis is a zoonotic bacterial disease, contracted by eating contaminated meat and milk from animals. People with this disease develop high fevers, dizziness, confusion, weakness, and muscle pain. The disease can be treated with antibiotics and a long course is required because the bacteria incubate inside the cells of the body. If the course is cut short, they can reemerge and cause another round of infection.
For patients with brucellosis, it is very important to adhere to a medication regimen, even though the medications will need to be taken long after it feels like the infection is over. This will reduce the development of antibiotic resistance and also ensure that the incubating bacteria do not have an opportunity to reinfect the patient. Person to person transmission is rare and it is safe to care for people with brucellosis without needing to worry about picking up the bacteria.
