Rickettsialpox in a New York City Hospital, 1980 to 1989

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Abstract
Rickettsialpox is caused by Rickettsia akari, which is transmitted from rodents to humans by bloodsucking mites. The initial skin lesion forms an eschar and is followed by the development of fever, malaise, myalgia, and 5 to 40 maculopapules and papulovesicles. The disease, which responds to tetracycline, can be mistaken for chickenpox. The diagnosis has been based on an increase in serum antibody titers against R. akari over a period of three to eight weeks. We discuss a more rapid technique that uses direct immunofluorescence to identify R. akari in paraffin-embedded tissue, and we describe the histopathological findings of lesional skin.