Rickettsiosis: A report on 19 cases hospitalized in the Infectious Diseases Department of the Ibn ROCHD University Hospital of Casablanca and a review of the literature

Introduction: Rickettsioses are emerging bacterial infections transmitted by arthropods, responsible for a wide clinical spectrum ranging from mild forms to severe multisystemic involvement.
Methods: We conducted a retrospective descriptive study including 19 patients hospitalized for rickettsiosis at the Ibn Rochd University Hospital in Casablanca between January 1, 2024, and December 31, 2025.
Results: The mean age was 33 years, with a male predominance (57.9%). All patients presented with fever, asthenia, and a skin rash. A black spot was observed in 68.4% of cases. Laboratory abnormalities included a consistent inflammatory syndrome, thrombocytopenia (94.7%), and hepatic and renal involvement. Five patients initially received ceftriaxone before being switched to doxycycline, while the others received doxycycline as first-line treatment. The outcome was favorable in all patients.
Conclusion: Rickettsiosis remains underdiagnosed. Probabilistic treatment with doxycycline should be initiated early in any case of clinical suspicion.