title: Rickettsia spp. 364D causing a cluster of eschar-associated illness, California.
abstract: We describe the clinical course of the first 3 pediatric cases infected with Rickettsia spp. 364D. Although the pathogen was identified in California ticks decades ago, only recently have human cases been documented. Clinical features are generally mild, characterized by eschar, fever, headache, malaise and lymphadenopathy. Antigenic similarity among rickettsiae leads to cross-reactive antibody responses; definitive diagnosis requires molecular methods.
authors.affiliation: From the *Children's Hospital & Research Center Oakland, Pediatric Infectious Diseases, Oakland; †California Department of Public Health, Center for Infectious Diseases, Richmond, CA; ‡Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA; §Lake County Public Health Department, Lakeport; and ¶Contra Costa Public Health, Martinez, CA.
authors.forename: Samantha H
authors.initials: SH
authors.lastname: Johnston
authors.forename: Carol A
authors.initials: CA
authors.lastname: Glaser
authors.forename: Kerry
authors.initials: K
authors.lastname: Padgett
authors.forename: Debra A
authors.initials: DA
authors.lastname: Wadford
authors.forename: Alex
authors.initials: A
authors.lastname: Espinosa
authors.forename: Natasha
authors.initials: N
authors.lastname: Espinosa
authors.forename: Marina E
authors.initials: ME
authors.lastname: Eremeeva
authors.forename: Karen
authors.initials: K
authors.lastname: Tait
authors.forename: Barbara
authors.initials: B
authors.lastname: Hobson
authors.forename: Sarit
authors.initials: S
authors.lastname: Shtivelman
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hsieh
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Messenger
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012281:Rickettsia / Q000145:classification* / Q000302:isolation & purification*; D012282:Rickettsia Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D017282:Tick-Borne Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*