Undifferentiated tropical fever: a case series of three Rickettsial infections

We report three cases of rickettsial infections diagnosed by performing a multiplex molecular syndromic panel, in patients who presented with undifferentiated tropical fever with non-specific clinical signs and symptoms. All three patients were from regions endemic to agents of tropical fever, such as dengue fever, leptospirosis, and typhoid fever, which were considered as differential diagnoses in the initial investigative workup. These cases highlight the need for a rapid syndromic diagnostic approach for tropical fever to enable timely diagnosis and institution of appropriate antibiotic therapy, as the typical empirical antibiotics for undifferentiated febrile illness, targeting the bacterial cell wall are ineffective in treating rickettsial infections.