Tick-borne infections: Difference between revisions
From IDWiki
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β | == |
+ | ==Clinical Manifestations== |
β | * |
+ | *Many of the diseases should be suspected in patients with: |
β | ** |
+ | **Flu-like illness that occurs not in flu season |
β | ** |
+ | **Β± cytopenias, Β± liver enzyme abnormalities |
β | ** |
+ | **Exposure history (outdoors activities, rats) |
β | == |
+ | ==By Disease== |
{| class="wikitable" |
{| class="wikitable" |
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! |
! |
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β | ! |
+ | !Lyme disease |
β | ! |
+ | !Babesiosis |
β | ! |
+ | !Anaplasmosis |
β | ! |
+ | !Ehrlichiosis |
β | ! |
+ | !RMSF |
|- |
|- |
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β | | |
+ | |Pathogen |
β | | |
+ | |''[[B. burgdorferi]]'' |
β | | |
+ | |''[[B. microti]]'' |
β | | |
+ | |''[[A. phagocytophilum]]'' |
β | | |
+ | |''[[E. chaffeensis]]'' |
β | | |
+ | |''[[R. rickettsii]]'' |
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|- |
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β | | |
+ | |Incubation |
β | | |
+ | |2-3 wk |
β | | |
+ | |1-4 wk |
β | | |
+ | |5-14 d |
β | | |
+ | |5-14 d |
β | | |
+ | |3-12 d |
|- |
|- |
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β | | |
+ | |Tick |
β | | |
+ | |[[Black-legged tick]] |
β | | |
+ | |[[Black-legged tick]] |
β | | |
+ | |[[Black-legged tick]] |
β | | |
+ | |[[Black-legged tick]], [[Lonestar tick]] |
β | | |
+ | |[[American dog tick]] |
|- |
|- |
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β | | |
+ | |Symptoms |
β | | |
+ | |Fever |
β | | |
+ | |Fever, HA, n/v/d |
β | | |
+ | |Fever, HA |
β | | |
+ | |Fever, HA, myalgias, n/v |
β | | |
+ | |Fever, HA |
|- |
|- |
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β | | |
+ | |Cells |
β | | |
+ | |Disseminates |
β | | |
+ | |Erythrocytes |
β | | |
+ | |Granulocytes |
β | | |
+ | |Monocytes |
β | | |
+ | |Vascular endothelial |
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β | | |
+ | |Rash |
β | | |
+ | |Erythema migrans |
β | | |
+ | |Rare |
β | | |
+ | |Rare |
β | | |
+ | |Maculopapular (30%) |
β | | |
+ | |Maculopapular; eschar with ''R. parkeri'' |
|- |
|- |
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β | | |
+ | |Labs |
β | | |
+ | |Uncommon |
β | | |
+ | |[[Hemolytic anemia]], [[thrombocytopenia]], liver enzymes |
β | | |
+ | |[[Leukopenia]], liver enzymes, [[thrombocytopenia]] |
β | | |
+ | |[[Leukopenia]] Β± [[lymphocytosis]], liver enzymes, [[thrombocytopenia]] |
β | | |
+ | |[[Thrombocytopenia]], liver enzymes, [[hyponatremia]] |
|- |
|- |
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β | | |
+ | |Complications |
β | | |
+ | |[[Carditis]], neuro sx, [[arthritis]] |
β | | |
+ | |[[DIC]], [[ARDS]], [[CHF]], [[AKI]] |
β | | |
+ | |Opportunistic infections, [[shock]] |
β | | |
+ | |[[Seizure]], [[coma]], [[CHF]], [[pericardial effusion]], [[shock]] |
β | | |
+ | |[[Coma]]/[[seizure]] (30%) |
|- |
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β | | |
+ | |Diagnosis |
β | | |
+ | |EM, serology |
β | | |
+ | |Microscopy |
β | | |
+ | |Serology, Β±microscopy |
β | | |
+ | |Serology, Β±microscopy |
β | | |
+ | |Serology, biopsy |
|- |
|- |
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β | | |
+ | |Mortality |
β | | |
+ | |Rare |
β | | |
+ | |3-20% |
β | | |
+ | |7-10% |
β | | |
+ | |2-5% |
β | | |
+ | |8% |
|- |
|- |
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β | | |
+ | |Treatment |
β | | |
+ | |[[Doxycycline]] |
β | | |
+ | |[[Azithromycin]], [[Atovaquone]] |
β | | |
+ | |[[Doxycycline]] |
β | | |
+ | |[[Doxycycline]] |
β | | |
+ | |[[Doxycycline]] |
|} |
|} |
||
β | == |
+ | ==By Tick== |
{| class="wikitable" |
{| class="wikitable" |
||
β | ! |
+ | !Tick |
β | ! |
+ | !Distribution |
β | ! |
+ | !Transmits |
β | ! |
+ | !Comments |
|- |
|- |
||
β | | |
+ | |American dog tick (''[[Dermacentor variabilis]]'') |
β | | |
+ | |East of the Rockies, and in limited areas in the Pacific coast |
β | | |
+ | |[[Tularemia]] and [[RMSF]] |
β | | |
+ | |Highest risk of bites in spring and summer. Sometimes called wood ticks. |
|- |
|- |
||
β | | |
+ | |Blacklegged (deer) tick (''[[Ixodes scapularis]]'') |
β | | |
+ | |Across the eastern US and in Ontario |
β | | |
+ | |[[Lyme disease]], [[Anaplasma]], ''[[B. miyamotoi]]'', [[ehrlichiosis]], [[babesiosis]], and [[Powassan virus]] |
β | | |
+ | |Highest risk in spring through fall, but can be found any time it's above freezing. |
|- |
|- |
||
β | | |
+ | |Brown dog tick (''[[Rhipicephalus sanguineus]]'') |
β | | |
+ | |Worldwide |
β | | |
+ | |[[RMSF]] |
β | | |
+ | |Dogs are the primary host but it can also bite humans. |
|- |
|- |
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β | | |
+ | |Gulf Coast tick (''[[Amblyomma maculatum]]'') |
β | | |
+ | |Coastal areas along the Guld of Mexico and southern Atlantic |
β | | |
+ | |''[[Rickettsia parkeri]]'' |
| |
| |
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|- |
|- |
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β | | |
+ | |Lone Star tick (''[[Amblyomma americanum]]'') |
β | | |
+ | |Southeastern and eastern United States |
β | | |
+ | |[[Ehrlichiosis]], [[Heartland virus]], [[tularemia]], [[STARI]] |
β | | |
+ | |Very aggressive tick. Irritation at site does not indicate infection. |
|- |
|- |
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β | | |
+ | |Rocky Mountain wood tick (''[[Dermacentor andersoni]]'') |
β | | |
+ | |Rocky Mountains and southwestern Canada from elevations of 4,000 to 10,500 feet |
β | | |
+ | |[[RMSF]], [[Colorado tick fever]], and [[tularemia]] |
| |
| |
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|- |
|- |
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β | | |
+ | |Western blacklegged tick (''[[Ixodes pacificus]]'') |
β | | |
+ | |Pacific coast of the U.S., particularly northern California |
β | | |
+ | |[[Anaplasmosis]] and [[Lyme disease]] |
|- |
|- |
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β | | |
+ | |Soft tick (''[[Ornithodoros]]'' species) |
β | | |
+ | | |
β | | |
+ | |[[Tick-borne relapsing fever]] (non-Lyme ''[[Borrelia]]'' species) |
β | | |
+ | |Short feeds at night, associated with rodents |
|} |
|} |
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β | == |
+ | ==Further Reading== |
+ | |||
β | * |
+ | *[https://tickencounter.org/tick_identification/tick_species TickEncounter tick identification], hosted by the University of Rhode Island |
[[Category:Vector-borne infections]] |
[[Category:Vector-borne infections]] |
Revision as of 10:01, 2 August 2020
Clinical Manifestations
- Many of the diseases should be suspected in patients with:
- Flu-like illness that occurs not in flu season
- Β± cytopenias, Β± liver enzyme abnormalities
- Exposure history (outdoors activities, rats)
By Disease
Lyme disease | Babesiosis | Anaplasmosis | Ehrlichiosis | RMSF | |
---|---|---|---|---|---|
Pathogen | B. burgdorferi | B. microti | A. phagocytophilum | E. chaffeensis | R. rickettsii |
Incubation | 2-3 wk | 1-4 wk | 5-14 d | 5-14 d | 3-12 d |
Tick | Black-legged tick | Black-legged tick | Black-legged tick | Black-legged tick, Lonestar tick | American dog tick |
Symptoms | Fever | Fever, HA, n/v/d | Fever, HA | Fever, HA, myalgias, n/v | Fever, HA |
Cells | Disseminates | Erythrocytes | Granulocytes | Monocytes | Vascular endothelial |
Rash | Erythema migrans | Rare | Rare | Maculopapular (30%) | Maculopapular; eschar with R. parkeri |
Labs | Uncommon | Hemolytic anemia, thrombocytopenia, liver enzymes | Leukopenia, liver enzymes, thrombocytopenia | Leukopenia Β± lymphocytosis, liver enzymes, thrombocytopenia | Thrombocytopenia, liver enzymes, hyponatremia |
Complications | Carditis, neuro sx, arthritis | DIC, ARDS, CHF, AKI | Opportunistic infections, shock | Seizure, coma, CHF, pericardial effusion, shock | Coma/seizure (30%) |
Diagnosis | EM, serology | Microscopy | Serology, Β±microscopy | Serology, Β±microscopy | Serology, biopsy |
Mortality | Rare | 3-20% | 7-10% | 2-5% | 8% |
Treatment | Doxycycline | Azithromycin, Atovaquone | Doxycycline | Doxycycline | Doxycycline |
By Tick
Tick | Distribution | Transmits | Comments |
---|---|---|---|
American dog tick (Dermacentor variabilis) | East of the Rockies, and in limited areas in the Pacific coast | Tularemia and RMSF | Highest risk of bites in spring and summer. Sometimes called wood ticks. |
Blacklegged (deer) tick (Ixodes scapularis) | Across the eastern US and in Ontario | Lyme disease, Anaplasma, B. miyamotoi, ehrlichiosis, babesiosis, and Powassan virus | Highest risk in spring through fall, but can be found any time it's above freezing. |
Brown dog tick (Rhipicephalus sanguineus) | Worldwide | RMSF | Dogs are the primary host but it can also bite humans. |
Gulf Coast tick (Amblyomma maculatum) | Coastal areas along the Guld of Mexico and southern Atlantic | Rickettsia parkeri | |
Lone Star tick (Amblyomma americanum) | Southeastern and eastern United States | Ehrlichiosis, Heartland virus, tularemia, STARI | Very aggressive tick. Irritation at site does not indicate infection. |
Rocky Mountain wood tick (Dermacentor andersoni) | Rocky Mountains and southwestern Canada from elevations of 4,000 to 10,500 feet | RMSF, Colorado tick fever, and tularemia | |
Western blacklegged tick (Ixodes pacificus) | Pacific coast of the U.S., particularly northern California | Anaplasmosis and Lyme disease | |
Soft tick (Ornithodoros species) | Tick-borne relapsing fever (non-Lyme Borrelia species) | Short feeds at night, associated with rodents |
Further Reading
- TickEncounter tick identification, hosted by the University of Rhode Island