- Rickettsia infection: Obligate intracelluar gram negative organism
- Flea bite (primary host is cat, rat, opossum)
- Southern and Central Texas; Southern California
- 5-15 day incubation
- Fever, headache, rash are the primary symptoms
- Also malaise, chills, myalgias
- 25% become severely ill (e.g. respiratory failure, shock, meningitis, renal failure, etc)
- Pink morbilliform rash, that starts on trunk and spreads outward (sparing soles, palms)
- Heaptomealy, conjunctivitis, splenomegaly in some
- Diagnosed on basis immunofluorescence assay
- Oftne elevated transmaminases, thrombocytopenia