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Rickettsia felis (R. felis) infection is a cause of unspecified encephalitis. However, the incidence has been underestimated due to the intracellular features of the pathogen and insufficient understanding of its clinical picture. This study reported a case of R. felis infection in a 26-year-old female who only manifested with certain neurological symptoms. With a lack of specific systemic inflammatory symptoms, the diagnosis was initially misdiagnosed as a brain glioma. However, a brain tissue biopsy showed prominent perivascular inflammatory infiltrations, which indicated inflammatory disease. Spinal fluid metagenomic next-generation sequencing (mNGS) was taken after ruling out other common infectious and autoimmune diseases. The results suggested R. felis infection, which was also supported by Weil-Felix reaction in the serum. After the diagnosis was corrected as R. felis encephalitis, the patient was successfully treated with doxycycline and had a good prognosis at the 1-year follow-up. Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.


Ziling Zeng, Chunjuan Wang, Cuicui Liu, Baojie Wang, Xin Meng, Yan Chen, Shougang Guo. Follow-up of a Rickettsia felis encephalitis: Some new insights into clinical and imaging features. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021 Mar;104:300-302

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PMID: 33444751

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