Editorial Commentary: A New Rickettsial Disease in the United States

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Abstract
The article by Paddock et al. [1] in this issue of Clinical Infectious Diseases demonstrates that we must be able to change our minds about traditionally established diseases such as Rocky Mountain spotted fever (RMSF) and tickborne rickettsioses. Paddock et al. [1] report the case of an American patient with fever, rash, and an inoculation eschar. The patient had antibodies to Rickettsia rickettsii and to Rickettsia akari. Culture of the eschar biopsy specimen yielded a rickettsia characterized by molecular biology as Rickettsia parkeri, which was discovered in ticks in the United States 60 years ago. This is the first report of an infection with this agent.