Rickettsioses are a diverse group of bacterial infections of the genus Rickettsia which are transmitted by arthropods. They are increasingly being recognised as the cause of acute febrile illness in travellers and in the inhabitants of tropical areas. In general, rickettsial disease should be considered if a patient presents with an acutely occurring febrile illness within less than 3 weeks of leaving an area where it is endemic. Other possible symptoms include malaise, myalgia, headache, and skin rash. An inoculation eschar is strongly suggestive of the diagnosis, but is often absent. As antibodies can sometimes only be demonstrated late in the disease process or after recovery, antibiotic therapy should be started as soon as the diagnosis is suspected on clinical grounds.