Case Report: Effective use of omadacycline in Japanese spotted fever

This case report describes the efficacy of omadacycline for the treatment of Japanese spotted fever. A 57-years-old woman presented with fever and maculopapular rash, followed by dyspnea. Laboratory abnormalities included respiratory failure, thrombocytopenia, liver dysfunction, and elevated inflammatory markers. Rickettsia japonica, the causative pathogen, was detected in bronchoalveolar lavage fluid (BALF). Based on the clinical manifestations, laboratory findings, and microbiological evidence, a diagnosis of Japanese spotted fever caused by Rickettsia japonica was considered. She received anti-infective therapy, intravenous polyene phosphatidylcholine, human albumin and platelet transfusions, along with symptomatic supportive care. After 14 days of omadacycline treatment, inflammatory markers and platelet counts normalized, and chest CT showed significant improvement, leading to full recovery and discharge. This case indicates that omadacycline may have contributed to the patient's recovery, alongside multiple concurrent treatments.