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Diagnosing Rickettsia felis infection with Metagenomic Next-Generation Sequencing (mNGS) in a patient with ankylosing spondylitis: a case report and literature review

Liu M, Cheng Y, Wang X, He Z, Yang K, Chen K, Fan Y, Wang W

Frontiers in immunology, 2025

2 citations

Abstract

Rickettsia felis, an emerging flea-borne pathogen with global distribution potential, is a neglected cause of undifferentiated febrile illness, although reported human cases remain sparse. The development of molecular diagnostic methods, along with the application of metagenomic next-generation sequencing (mNGS), has improved the diagnostic accuracy of infectious fevers. A case of Rickettsia felis infection was diagnosed by mNGS in a 55-year-old patient with pre-existing ankylosing spondylitis. Five previously reported cases of Rickettsia felis infection were systematically reviewed, with a comprehensive analysis of their epidemiological characteristics, clinical manifestations, and therapeutic regimens. This study highlights the clinical features and diagnostic approaches of the disease through a case report and literature review.

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