During 2014-2017, we screened for Rickettsia japonica infection in Xinyang, China, and identified 20 cases. The major clinical manifestations of monoinfection were fever, asthenia, myalgia, rash, and anorexia; laboratory findings included thrombocytopenia and elevated hepatic aminotransferase concentrations. Physicians in China should consider R. japonica infection in at-risk patients.
Keywords: China; Rickettsia japonica; bacteria; emerging infectious diseases; hepatic aminotransferases; laboratory tests; signs and symptoms; spotted fever group rickettsioses; thrombocytopenia; tickborne disease; ticks; vector-borne infections.