Abstract
Australia has 4 rickettsial diseases: murine typhus, Queensland tick typhus, Flinders Island spotted fever, and scrub typhus. We describe 7 cases of a rickettsiosis with an acute onset and symptoms of fever (100%), headache (71%), arthralgia (43%), myalgia (43%), cough (43%), maculopapular/petechial rash (43%), nausea (29%), pharyngitis (29%), lymphadenopathy (29%), and eschar (29%). Cases were most prevalent in autumn and from eastern Australia, including Queensland, Tasmania, and South Australia. One patient had a history of tick bite (Haemaphysalis novaeguineae). An isolate shared 99.2%, 99.8%, 99.8%, 99.9%, and 100% homology with the 17 kDa, ompA, gltA, 16S rRNA, and Sca4 genes, respectively, of Rickettsia honei. This Australian rickettsiosis has similar symptoms to Flinders Island spotted fever, and the strain is genetically related to R. honei. It has been designated the "marmionii" strain of R. honei, in honor of Australian physician and scientist Barrie Marmion.
Highlights
It is found in southeastern Australia and is characterized by fever, headache, myalgia, transient arthralgia, maculopapular rash, and cough in some cases [6,7]
We describe 7 cases of a rickettsial disease similar to FISF, which occurred in the eastern half of Australia
In 5 of 6 patients a rickettsia was isolated from blood in Vero cell culture, 4 of these 5 isolates did not persist in cell culture after their third passage
Summary
Rickettsial serology later showed an increase in antibody titer Both PCR and culture results were positive for an SFG rickettsia (Table 1). She was initially thought to have a viral illness; after 3 days she was still febrile (39.0°C), and the provisional diagnosis was changed to scrub typhus; a regimen of oral doxycycline, 100 mg per day, was begun. She was not seen by medical or nursing staff between day 3 and 8 of the illness, but was afebrile and well by day 8. Results of serologic investigations for Plasmodium falciparum and rickettsia (taken on day 3)
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