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Diagnosis
The laboratory tests available for the diagnosis of Rickettsial species includes: shell vial assay, PCR-based detection, immunodetection, circulating endothelial cells, and serodiagnostic tests such as the Weil-Felix test, CF test, ELISA, microimmunofluorescence, immunoperoxidase, line blot and Western immunoblot tests.

Traditionally, the diagnosis of Rickettsia was based on serology However, serologic tests often don't differentiate the species of Rickettsia and it takes about 15 days after the onset of symptoms for there to be diagnostically significant titers of R. tyhpi. And so the diagnosis is often confirmed after the patient has either recovered or died. Laboratory techniques such as real-time PCR and microimmunofluorescence can be used to identify Rickettsia down to the species level. Microimmunofluorescence is a highly sensitive test that is often used in endemic areas to confirm infection by R. typhi. The use of real-time PCR can allow for the detection and confirmation of R. typhi earlier than serological tests.