Rickettsial diseases are still prevalent in most of the countries including India and are also classified under the causes of pyrexia of unknown origin (PUO). Early signs and symptoms of these infections are nonspecific making diagnosis more difficult. If untreated mortality may be as high as 30-35% . Though Weil Felix test is less sensitive but still it serves as a useful and cheapest available screening tool for the laboratory diagnosis of rickettsial diseases. A prospective study was carried out for a period of 6 months from November 2015 to April 2016 in a tertiary-care hospital, Shimoga, Karnataka, India. The serum samples from 277 PUO cases which included patients of all age group and from both Out Patient Department (OPD) and In Patient Department (IPD), were subjected to Weil–Felix test (PROGEN, Tulip Diagnostics (P) Ltd., Verna, Goa, India). The test was performed according to the manufacturer’s instructions. Serum samples positive in the slide test were confirmed with the tube test. Titers of more than 1:160 for OX-K and more than 1:80 for OX-2 and OX-19 were considered significant. Of 277 samples, rickettsial diseases were detected in 73(26.35%) samples. Seropositivity was higher among male subjects 52(71.23%) when compared with female subjects 21(28.77%). All positive cases were in 1-18 age group. Prevalence of rickettsial diseases 73(26.35%) is significantly high, especially in children’s and hence should be included in the differential diagnosis of PUO.

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