In the scenario of overwhelming bacterial, viral infections and parasitic infestations, rickettsial
diseases are an ignored lot. They can present with a myriad of symptoms like fever, headache,
rash, meningitis, congestive cardiac failure and shock. They can closely mimic multiple
illnesses like meningococcaemia, enteric fever, dengue, leptospirosis and sometimes even leukaemia.
The Weil Felix test supported by clinical and epidemiological features of each patient
can help to clinch the diagnosis especially when other serodiagnosis facilities are not available.
Here we present three cases, all coming from same rural area of Western India, with varied
presentations who responded dramatically to anti rickettsial therapy.