Rickettsial Infection — RACP Paediatrics MCQ

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ModerateInfectious DiseaseRickettsial InfectionRACP Paediatrics

A 10-year-old presents with high fever, headache, myalgia, and a blanching maculopapular rash following a bushwalking trip in Queensland. He was bitten by ticks 7 days ago. What is the most likely diagnosis?

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Correct answer: A — Rickettsial infection (Queensland tick typhus / Rickettsia australis)

Queensland tick typhus (caused by Rickettsia australis) presents with fever, headache, maculopapular rash, regional lymphadenopathy, and often an eschar at the tick bite site. Treatment is oral doxycycline (even in children <8 years for short courses for rickettsial infections). It is endemic in eastern coastal Australia.

Reference: Therapeutic Guidelines – 2024 – Antibiotic: Rickettsial Infections