Work

Clinical characteristics analysis of five cases of Japanese spotted fever rickettsia infection

Year: 2026

Type: article

Abstract: Aims This study aimed to analyze the clinical characteristics and treatment strategies of Japanese spotted fever (JSF) cases clustered in the same region over a short period, to provide clinical insights for the diagnosis and management of similar cases. Methods Data of 5 JSF cases admitted to Dazhu County, Sichuan and surrounding areas from May to September 2025 were collected. Epidemiological features, clinical manifestations, laboratory/auxiliary findings, treatment regimens and prognoses were systematically analyzed, and common points in diagnosis and management were summarized. Results One severe and four mild cases were included, all with long-term residence in Dazhu and surrounding endemic areas; four had outdoor exposure, while the severe case had potential vector exposure in a domestic environment with reported rodent presence. All presented with fever and rash: the severe case had myalgia, diarrhea, septic shock and multiple organ dysfunction, while mild cases mainly had abnormal liver function and hypokalemia. Laboratory abnormalities included elevated neutrophil percentage/C-reactive protein increased, alanine transaminase/aspartate transaminase, and had chest CT-proven lung infection. All received doxycycline: mild cases with monotherapy or combined with piperacillin-tazobactam/symptomatic care (hepatoprotection, potassium supplementation); the severe case additionally received platelet-elevating agents, fluid resuscitation, acid correction, anti-shock therapy, albumin and multi-organ support. Conclusion All 5 patients were cured after standardized treatment. Early identification, targeted anti-infective therapy and multi-organ support are crucial for JSF prognosis, offering supportive observations for regional rickettsial infection prevention and control. Clinical trial number Not applicable.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-026-14301-7