Approach

Rickettsial infections are relatively common infections in travellers returning from tropical or developing countries. In most febrile returned travellers, malaria should be considered first and ruled out before considering other causes. Once malaria is ruled out, rickettsial infection should be considered along with other potential causes including sepsis, typhoid fever, leptospirosis, dengue fever, chikungunya virus infection, Zika virus infection, Q fever, brucellosis, mycobacterial infection (including tuberculosis), or a sexually transmitted disease.

Rickettsial infections are a notifiable disease in some countries. 

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