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Diagnosis

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The laboratory tests available for the diagnosis of Rickettsial species includes: shell vial assay, PCR-based detection, immunodetection, circulating endothelial cells, and serodiagnostic tests such as the Weil-Felix test, CF test, ELISA, microimmunofluorescence, immunoperoxidase, line blot and Western immunoblot tests [1].

Traditionally, the diagnosis of Rickettsia was based on serology [2] However, serologic tests often don't differentiate the species of Rickettsia [2] and it takes about 15 days after the onset of symptoms for there to be diagnostically significant titers of R. tyhpi [3]. And so the diagnosis is often confirmed after the patient has either recovered or died [1]. Laboratory techniques such as real-time PCR and microimmunofluorescence can be used to identify Rickettsia down to the species level [4][5]. Microimmunofluorescence is a highly sensitive test that is often used in endemic areas to confirm infection by R. typhi [5]. The use of real-time PCR can allow for the detection and confirmation of R. typhi earlier than serological tests [4].


  1. ^ a b Scola, B. La; Raoult, D. (1997-11-01). "Laboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseases". Journal of Clinical Microbiology. 35 (11): 2715–2727. doi:10.1128/jcm.35.11.2715-2727.1997. ISSN 0095-1137. PMID 9350721.
  2. ^ a b "Rickettsia typhi (Murine typhus)- Infectious Disease and Antimicrobial Agents". www.antimicrobe.org. Retrieved 2020-09-23.
  3. ^ Dumler, J. S. (1991-09-11). "Clinical and laboratory features of murine typhus in south Texas, 1980 through 1987". JAMA: The Journal of the American Medical Association. 266 (10): 1365–1370. doi:10.1001/jama.266.10.1365. ISSN 0098-7484.
  4. ^ a b Giulieri, Stefano; Jaton, Katia; Cometta, Alain; Trellu, Laurence T.; Greub, Gilbert (2012-02-01). "Development of a duplex real time PCR for the detection of Rickettsia spp. and typhus group rickettsia in clinical samples". FEMS Immunology & Medical Microbiology. 64 (1): 92–97. doi:10.1111/j.1574-695X.2011.00910.x. ISSN 0928-8244.
  5. ^ a b Schriefer, M E; Sacci, J B; Dumler, J S; Bullen, M G; Azad, A F (1994). "Identification of a novel rickettsial infection in a patient diagnosed with murine typhus". Journal of Clinical Microbiology. 32 (4): 949–954. doi:10.1128/jcm.32.4.949-954.1994. ISSN 0095-1137.