Urban rickettsiosis in the Waikato region of New Zealand.

Murine typhus is the only endemic rickettsia that has been shown to cause human disease in New Zealand (NZ). We present a case report of a rickettsial infection in the Waikato region which was not typical for murine typhus. We outline the features which made this case unusual, and discuss the diagnostic uncertainty in assessing rickettsial disease. Rickettsial infection should be suspected in all patients presenting with an undifferentiated febrile illness in NZ, even if they do not fit the typical clinical and epidemiological picture of murine typhus.