Central infection with Rickettsia felis complicated with stroke: A case series and review

作者：Jiongfei Jin, Fei Dong, Er-Wei Xu, Dandan Wu · 发表于：IDCases · 年份：2025 · DOI：10.1016/j.idcr.2025.e02341 · 被引用次数：4 · 研究领域：Vector-borne infectious diseases、Rabies epidemiology and control、Yersinia bacterium, plague, ectoparasites research

Rickettsia felis ( R. felis ) is an emerging pathogen primarily transmitted by fleas, with clinical manifestations similar to other rickettsial infections. Although rare, severe cases involving central nervous system complications, such as meningoencephalitis, have been reported. This article presents three cases of R. felis central infections complicated by stroke. Two patients experienced cerebral infarctions, while another had a subarachnoid hemorrhage. Analysis of cerebrospinal fluid revealed common features, including elevated protein levels and increased nucleated cells with lymphocytic predominance. This report emphasizes the importance of considering R. felis as a potential cause of stroke in febrile patients, and highlights the role of advanced diagnostic techniques, such as next-generation sequencing (NGS), in the timely identification of rare pathogens. Early detection and appropriate treatment are crucial for optimizing patient outcomes. • We reviewed 3 cases of R. felis central infection, all of them complicated with stroke. • In cryptogenic stroke patients with fever, consider testing for R. felis infection. • This study analyzed and summarized the cerebrospinal fluid (CSF) characteristics in patients R. felis central infection.