Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Rickettsia spp. — Rickettsia infections (boutonneuse fever)

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 29 October 2026 · Methodology

Rickettsiaceae · Gram stain not contributive

Bactéries intracellulaires obligatoires transmises par les tiques (R. conorii — fièvre boutonneuse méditerranéenne), les poux (R. prowazekii — typhus épidémique) ou les acariens (R. akari). France méditerranéenne : R. conorii fréquente. Triade classique : fièvre + escarre d'inoculation (tache noire) + exanthème maculopapuleux (peut toucher paumes et plantes). MORTALITÉ si retard de traitement. Traitement de choix : DOXYCYCLINE, chez l'adulte en deux prises, duration not verified — see cited source ; chez l'enfant, doxycycline si > 20 kg, azithromycine si < 20 kg ; en cas d'allergie, azithromycine (HAS 2025) — NE PAS ATTENDRE la confirmation biologique pour traiter. Beta-lactamines inefficaces (bactérie intracellulaire).

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Rickettsia spp. are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Skin — Escarre + exanthème	High tropism	Evidence B	1	direct
Central nervous system — Méningo-encéphalite	Moderate tropism	Evidence B	1	hematogenous
Lung	Moderate tropism	Evidence B	1	not recorded
Liver / Bile duct	Moderate tropism	Evidence B	1	not recorded

Described portals of entry

• Skin

Spread routes recorded: 2 of 4 documented foci A focus without a route is not a focus without spread: the route is simply not recorded.

Sources

• Biggs HM et al. — CDC Diagnosis and Management of Tickborne Rickettsial Diseases (MMWR) (2016) — doi:10.15585/mmwr.rr6502a1

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