Identification of Rickettsia conorii Indian tick typhus strain in a Patient and an Attached Rhipicephalus turanicus Tick in Xinjiang, China

Rickettsia conorii Indian tick typhus strain (R. conorii subsp. indica, ITTR) was detected in both a human patient and an attached Rhipicephalus turanicus tick that was removed from the patient in Yanqi County, Xinjiang Uygur Autonomous Region (XUAR), China. The molecular identification of the pathogen, along with previous reports, suggests it may be distributed across the area. A 55-year-old female farmer presented with fever, headache, eschar, and a maculopapular rash following a tick bite. Laboratory findings indicated thrombocytopenia, liver enzyme elevation, and proteinuria, which, combined with clinical symptoms, strongly suggested a rickettsial infection. PCR and sequencing of multiple rickettsial genes confirmed the presence of ITTR in both the patient and the tick. Furthermore, the genetic identity between these sequences provided evidence that R. turanicus can act as a vector of ITTR. This case provides valuable insights into the clinical manifestation, diagnosis, and treatment of ITTR infections. These findings highlight the need for improved surveillance and awareness of tick-borne rickettsial diseases in regions with high tick exposure.