Introduction: Spotted fever group rickettsioses are an interesting group of infections, which are increasing in incidence worldwide.
Case presentation: Here we describe an imported case to the United Kingdom occurring in a patient who had recently visited Kruger National Park in South Africa - a highly endemic area for Rickettsia infections. Initial treatment with doxycycline failed but the patient made a prompt recovery after commencement of ciprofloxacin.
Conclusion: This finding raises the possibility that there are resistant strains of Rickettsia present.