An update on the detection and treatment of Rickettsia felis

Figures & data

Table 1 Summary of Rickettsia felis–specific diagnostic/confirmatory methods and treatment reported in human infection

Country	Year of publication	N cases confirmed	R. felis-specific detection and identification methods*	Specific R. felis treatment and outcome	Reference
USA	1994	1	PCR 17-kDa protein gene fragment RFLP Southern hybridization	Doxycycline	66
Brazil	2001	2	MIF antibody titers to R. felis higher by two or more dilutions Nested PCR gltA gene fragment, sequencing (1 patient)	NI	36
Mexico	2000	3	PCR 17-kDa protein gene fragment; sequencing	Doxycycline 2 weeks (one patient), recovered	67
	2006	1	PCR 17-kDa protein gene fragment, sequencing	Doxycycline, discharged after 1 week Chloramphenicol	68
	2009	2	PCR gltA, ompA, ompB, gene fragments, sequencing and RFLP	(IV 75 mg/kg per day for 10 days), both recovered within 5 days	69
France	2001	2	MIF antibody titers to R. felis higher by two or more dilutions	NI	36
	2009	1	MIF, R. felis confirmed by Western blot with cross-adsorption	Doxycycline, rapid improvement	70
Germany	2002	1	Seroconversion, MIF antibody titers to R. felis higher by two or more dilutions, species confirmed by Western blot Nested PCR for PS120 protein gene fragment	Doxycycline (200 mg/day for 7 days), recovered within 3 days	52
Thailand	2003	1	MIF antibody titers to R. felis higher by two or more dilutions, species confirmed by Western blot	Doxycycline (200 mg/day for 7 days)	76
South Korea	2005	3	Nested PCRs ompB and gltA gene fragments, RFLP and sequencing	NI	74
Spain	2005	5	MIF antibody titers to R. felis higher by two or more dilutions, species confirmed by Western blot with cross-adsorption	NI	54
	2006	2	Nested PCRs gltA and ompB gene fragment, seminested PCR ompA, sequencing	Doxycycline (200 mg/day for 10 days), recovered within 2 days	71
Tunisia	2006	8	MIF, Western blot with cross-adsorption	NI	78
	2009	1	MIF, Western blot with cross-adsorption	Tetracycline and doxycycline	79
Laos	2006	1	MIF, Western blot with cross-adsorption	NI	77
Egypt	2007	1	Quantitative real-time PCR specific for R. felis ompB gene fragment	NI	80
Israel	2010	1	Quantitative real-time PCR specific for R. felis ompB gene fragment	Doxycycline	73
Kenya	2010	6	Quantitative real-time and nested PCR 17 kDa protein gene fragments, sequencing Quantitative real-time PCR specific for R. felis ompB gene fragment Nested PCR ompB gene fragment, sequencing	NI	83
	2012	21	PCR R. felis plasmid PCR 17-kDa protein gene, ompB, R. felis plasmid gene fragments, sequencing Quantitative real-time PCR specific for R. felis ompB gene fragment	NI	84
Australia	2011	5 (probable)	MIF, high titers or seroconversion to TG rickettsiae PCR gltA gene fragment from cat fleas, sequencing	Doxycycline (one patient), improved	81
Senegal	2010	8	Quantitative real-time and nested PCR gltA gene fragments, sequencing Quantitative real-time PCR biotin synthase R. felis-specific gene fragment	NI	82
Taiwan	2008	1	Quantitative real-time PCR 17-kDa protein, groEL, ompB gene fragments, sequencing	Doxycycline (oral 100 mg every 12 hours for 5 days)	75
Sweden	2010	2	Quantitative real-time PCR gltA; nested PCR 17-kDa protein and ompB gene fragments, sequencing	Nonspecific antibiotics	72
New Zealand	2012	2	MIF, R. felis confirmed by Western blot with cross-adsorption	NI	85

Note:

* PCRs not specific for R. felis unless otherwise stated.

Abbreviations: PCR, polymerase chain reaction; RFLP, restriction fragment length polymorphism; MIF, microimmunofluorescence; NI, not indicated or not applicable.