Current Infectious Disease Reports

, Volume 11, Issue 1, pp 66–72 | Cite as

Scrub typhus and rickettsial diseases in international travelers: A review

  • Edward F. Hendershot
  • Daniel J. Sexton


Physicians caring for febrile returned travelers face the difficult task of recognizing the typical and atypical features of more than 16 known rickettsial diseases and separating these diseases from potentially serious nonrickettsial diseases. Currently available diagnostic tools are inadequate for timely diagnosis. This review summarizes the English-language literature concerning imported rickettsial diseases in international travelers and describes important clinical principles in diagnosis and treatment of these illnesses. Travelers with imported rickettsial disease often become sick before or within a few days of return from an endemic region. Illness that begins more than 18 days after return is unlikely to be rickettsial in origin. The absence of a skin rash or exposure to a vector should not dissuade clinicians from considering the possibility of a rickettsial disease in a returned traveler. Finally, if empiric therapy does not result in defervescence within 48 hours, an alternative nonrickettsial illness should be strongly considered.


Typhus Scrub Typhus Emerg Infect Spotted Fever Spotted Fever Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Current Medicine Group LLC 2009

Authors and Affiliations

  1. 1.Division of Infectious DiseasesDuke University Medical CenterDurhamUSA

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