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Queensland Tick Typhus — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesQueensland Tick TyphusRACP Adult Medicine

A 42-year-old man recently returned from Queensland presents with high fever, headache, myalgia, and a maculopapular rash spreading from his trunk. Blood film is negative for malaria parasites. Serology returns positive for Rickettsia australis. What is the first-line treatment?

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Correct answer: B — Doxycycline 100 mg BD

Queensland tick typhus (caused by Rickettsia australis) is an important Australian rickettsial infection transmitted by Ixodes ticks. Doxycycline is first-line treatment for all rickettsial infections. It should be commenced empirically when rickettsiosis is suspected without waiting for serology. The classic triad is fever, headache, and rash (often with an eschar at the tick bite site).

Reference: eTG – 2025 – Antibiotic Guidelines; CDNA – 2021 – Rickettsial Infections