Endemic spotted fever

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1C30.2

Flea spotted fever, murine spotted fever, rat spotted fever.

Notifiable rickettsial disease, which is similar to epidemic typhus but milder.

  • Pathogen: Rickettsia typhi
  • Transmission is by the rat flea

  • Like epidemic typhus, but much milder
  • Unspecific early stage (cephalgia, exhaustion)
  • In the course: Fever, somnolence
  • 3-6 days after onset of fever Appearance of roseolae with partly punctate haemorrhages on the trunk, which spread centrifugally. Palmoplantar involvement
  • Muscle twitching, tenderness of peripheral nerves, motor restlessness
  • Hypotonia
  • Bronchitis, conjunctivitis, splenomegaly
  • Mostly lice can be detected (pediculosis corporis)
  • Facies typhosa: Livid-reddish face

  • Anamnesis
  • Clinic
  • Lice infestation
  • BB (mild leukocytosis or leukopenia, eosinophilia, thrombocytopenia), liver and kidney values (elevated transaminases in up to 90%), electrolytes (hyponatremia)
  • Lumbar puncture in case of suspected meningitis
  • From the 2nd week of illness Weil-Felix reaction (agglutination test)
  • From the 3rd week of illness, complement fixation reaction
  • From the 3rd week of illness indirect immunofluorescence test

  1. De Sousa, R., et al., Molecular detection of Rickettsia felis, Rickettsia typhi and two genotypes closely related to Bartonella elizabethae. Am J Trop Med Hyg, 2006. 75(4): p. 727-31.
  2. McLeod, M.P., et al., Complete genome sequence of Rickettsia typhi and comparison with sequences of other rickettsiae. J Bacteriol, 2004. 186(17): p. 5842-55.
  3. Nogueras, M.M., et al., Serological evidence of infection with Rickettsia typhi and Rickettsia felis among the human population of Catalonia, in the northeast of Spain. Am J Trop Med Hyg, 2006. 74(1): p. 123-6.