Rickettsia felis identified in two fatal cases of acute meningoencephalitis
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Updated: Jun 16, 2026

Extraction of Saliva, Haemolymph, Salivary Glands, and Midgut from Individual Ticks (Acari: Ixodidae)
Published on: October 31, 2025
Arthur H P Mawuntu1, Edison Johar2, Riane Anggraeni1
1Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia.
Background:
Rickettsia felis has recently emerged worldwide as a cause of human illness. Typically causing mild, undifferentiated fever, it has been implicated in several cases of non-fatal neurological disease in Mexico and Sweden. Its distribution and pathogenicity in Southeast Asia is poorly understood.
Methodology/Principal Findings:
We retroactively tested cerebrospinal fluid (CSF) or sera from 64 adult patients admitted to hospital in North Sulawesi, Indonesia with acute neurological disease. Rickettsia felis DNA was identified in the CSF of two fatal cases of meningoencephalitis using multi-locus sequence typing semi-nested PCR followed by Sanger sequencing. DNA from both cases had 100% sequence homologies to the R. felis reference strain URRWXCal2 for the 17-kDa and ompB genes, and 99.91% to gltA.
Conclusion/Significance:
The identification of R. felis in the CSF of two fatal cases of meningoencephalitis in Indonesia suggests the distribution and pathogenicity of this emerging vector-borne bacteria might be greater than generally recognized. Typically Rickettsia are susceptible to the tetracyclines and greater knowledge of R. felis endemicity in Indonesia should lead to better management of some acute neurological cases.
Insights
Rickettsia felis, an emerging bacteria, was identified in fatal meningoencephalitis cases in Indonesia. This finding suggests a wider distribution and greater pathogenicity of R. felis than previously recognized in Southeast Asia.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Rickettsia felis is an emerging cause of human illness globally.
- It typically causes mild fever but has been linked to non-fatal neurological disease.
- Its presence and impact in Southeast Asia remain largely unknown.
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