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Open AccessArticle

Clinical Manifestations and Outcomes of Rickettsia australis Infection: A 15-Year Retrospective Study of Hospitalized Patients

Department of Infectious Diseases, Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia
Australian Rickettsial Reference Laboratory, Geelong, VIC 3220, Australia
School of Medicine, University of Queensland, Brisbane, QLD 4067, Australia
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2017, 2(2), 19;
Received: 15 May 2017 / Revised: 13 June 2017 / Accepted: 17 June 2017 / Published: 20 June 2017
(This article belongs to the Special Issue The Past and Present Threat of Rickettsial Diseases)
PDF [404 KB, uploaded 20 June 2017]


Queensland tick typhus (QTT; Rickettsia australis) is an important cause of community-acquired acute febrile illness in eastern Australia. Cases of QTT were identified retrospectively from 2000 to 2015 at five sites in Northern Brisbane through a pathology database. Those included had a fourfold rise in spotted fever group (SFG)-specific serology, a single SFG-specific serology ≥ 256 or SFG-specific serology ≥ 128 with a clinically consistent illness. Cases were excluded on the basis of clinical unlikelihood of QTT infection. Thirty-six cases were included. Fever was found in 34/36 (94%) patients. Rash occurred in 83% of patients with maculopapular being the dominant morphology (70%). Thrombocytopenia, lymphopenia, and raised transaminases were common and occurred in 58%, 69%, and 89% of patients, respectively. Thirty-one of 36 (86%) patients received antibiotic therapy (usually doxycycline) and the time to correct antibiotic (from admission) ranged from 3 to 120 h (mean 45.5 h). Four of 36 (11%) required intensive care unit (ICU) admission for severe sepsis and end-organ support. There were no deaths. QTT has a wide range of clinical and laboratory features. Early and appropriate antimicrobial therapy is important and may prevent severe disease. Further prospective studies are required to identify factors associated with severe infection and sepsis. View Full-Text
Keywords: tick-borne diseases; rickettsial infections; bacteriology tick-borne diseases; rickettsial infections; bacteriology

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Stewart, A.; Armstrong, M.; Graves, S.; Hajkowicz, K. Clinical Manifestations and Outcomes of Rickettsia australis Infection: A 15-Year Retrospective Study of Hospitalized Patients. Trop. Med. Infect. Dis. 2017, 2, 19.

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