Human Rickettsia felis infections in Mainland China

We identified four flea-borne spotted fever cases caused by Rickettsia felis in a retrospective survey of 182 patients with fever of unknown origin (FUO) in China between 2021 and 2022. The clinical signs and symptoms of the patients were similar to those of other rickettsioses, including fever, rash, and liver and kidney dysfunction. All four patients in the present study developed pneumonia or lung lesions after R. felis infection. The cases of R. felis infection, a neglected infectious disease, were sporadic in multiple provinces of the country. The high prevalence (2.14%, 4/187) of R. felis among patients with FUO highlights the risk posed by this pathogen to public health in China.

Automated summary

We identified four cases of flea-borne spotted fever caused by Rickettsia felis in a retrospective survey of 182 patients with fever of unknown origin in China. The clinical signs and symptoms of these patients were similar to other rickettsial diseases, including fever, rash, and liver and kidney dysfunction. All four patients in the study developed pneumonia or lung lesions after R. felis infection. The cases of R. felis infection were sporadic in multiple provinces of China, highlighting the risk posed by this neglected infectious disease to public health.