The first pediatric cohort of Rickettsia conorii infection in Palestine: A five-year multicenter epidemiological and clinical analysis

This first pediatric cohort in Palestine supports MSF as endemic, seasonally clustered, and largely benign when promptly treated. Fever with rash, even without eschar, may raise suspicion for rickettsiosis in summer. Early recognition and empirical doxycycline therapy remain key to preventing morbidity. Enhanced surveillance and clinician awareness are essential to improve diagnosis and control of pediatric MSF in the region.