A case of paediatric spotted fever presenting with acute hepatitis and encephalopathy

Rickettsial infections caused by the spotted fever group Rickettsia remain an underrecognized cause of acute febrile illness in children, particularly in endemic regions. Although fever and rash constitute the classical presentation, atypical organ involvement may occur, leading to diagnostic delay. We report a rare presentation of pediatric spotted fever complicated by acute hepatitis and encephalopathy in a child from a rural agricultural background. The child initially presented with fever, anorexia, and malaise, followed by jaundice and altered sensorium. Extensive evaluation excluded common viral, bacterial, and parasitic etiologies. Serological testing supported the diagnosis of spotted fever, and prompt initiation of doxycycline resulted in rapid clinical and biochemical improvement. This case emphasizes the importance of maintaining a high index of suspicion for rickettsial infections in children presenting with unexplained hepatic and neurological involvement, even in the absence of rash or eschar. A child from a rural area developed an uncommon form of spotted fever affecting the liver and brain. Early recognition and treatment with doxycycline led to complete recovery, highlighting the need to consider rickettsial infections even when classical symptoms are absent.  

• Publication year

  2026

• Venue

  International Journal of Contemporary Pediatrics

• Publication date

  2026-01-27

• Fields of study

  Not labeled

• Identifiers
  DOI 10.18203/2349-3291.ijcp20260115
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

• IAP guidelines on rickettsial diseases in children

  2017cited by this paper
• Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States.

  2016cited by this paper
• Rickettsial infections: Indian perspective

  2010cited by this paper
• Ticks and tickborne bacterial diseases in humans: an emerging infectious threat.

  2001cited by this paper

• No citing papers are available for this paper.