Tick bites a common cause of fever of unknown origin in China

Rickettsioses are more common than previously realized and may be associated with misdiagnosed causes of fever, researchers from north east China say. In an article in NEJM they describe 251 patients who had recent tick bites sought treatment at Mudanjiang Forestry Central Hospital. None of the patients presented with rash, which is considered to be a typical sign of infections with species of rickettsiae of the spotted fever group in China. Thus their conditions were initially misdiagnosed, and they received penicillin G, leading to a prolonged hospitalization for approximately 20 days.
Read the full study at NEJM