Ticks and More Ticks Flashcards
Scrub typhus
orienta tsutugamushi
louse born relapsing fever
borrelia recurrentis
TIck borne relapsing fever
borellia hermsii, borellia turicatae
boutonneuse fever?
also known as mediterranean fever, rickettissia conorii
louse-borne endemic typhus
rickettisa prowazekii
endemic (murine) typhus?
rickettsia typhi
tick borne diseases general principles?
flu-like illness with empiric treatment, prognosis worse on extremes of age (<10/>60), with doxycycline is preferred therapy for most.
lab tip offs for tick borne illnesses?
thrombocytopenia, elevated LFTs, WBC abnormality
what are the 4 basic life stages of ticks?
egg–>larva–>mymph–> adult
what are the two major types of human disease vectors?
mosquitos is 1, ticks is 2
what are the two major groups of rickettsial species
spotted fever group (rickettsia), Typhus group (epidemic - rickettsia prowazekii (body louse), murine/endemic - rickettisa typhus (rat flea))
RMSF rash description?
Early: Rash absent/maculopaular on extremeties moving towards petechial
What labs do you see with RMSF?
Leukocytosis, thrombocytoepnia, transaminitis
How is RMSF diagnosed?
Skin biopsy immunochemistry (DFA) is 70% sensitive. Seroconversion occurs 7-10 days after onset of symptoms. IFA gold standard but can x react. IgG/IgM can persist long after recovery
Rickettsia Parkeri transmission/unique symptoms?
Lone star or gulf coast ticks transmission vector. See headache, mylagia with faint salmon colored rash with single or multiple eschars
Clinical characteristics of Ricketssia Africae infection?
Fever, neck muscle myalgia, vesicular rash, lymphadenopathy. But, multiple eschars and inoculation eschars are unique
Returning traveler with fever. common causes?
Malaria, typhoid, and R.Africae
clinical characteristics of rickettsial pox?
Organism: R.Akari, Reservoir: house mouse, vector: house mites, Clinical: Single eschar, 20-40 papulovesicular rash. Dx with PCR swab eschar/vesicle. tx with doxycycline
ddx of vesicular rash?
HSV, VZV, Pox viruses, ricketsialpox, african tick bite fever, queensland tick typhus
Scrub typhus organism and vector?
Orientia tsutsugamushi is organism, vector is trombiculid mite (chiggers)
Geography of scrub typhus?
Triangle from Japan to eastern australia to southern russia
Clinical presentation of scrub typhus? TX?
Eschar, painful/draining lymph nodes, rash, delirium that may progress to MODS. treat with doxycyclinex 7 days/azithromycin
flying squirrels association?
Epidemic typhus or R.Prowazekii
vector/population of R.Prowazekii?
Louse(body/head), with crowded conditions
vector/population of R.typhi?
Flea (rat, cat) worldwide/texas, US southern california
what is the difference in vectors between HME and HGA?
HME vector is lone star tick (E.Chaffeensis) and HGA is ixodes scapularis (anaplasma phagocytophilum).
Clinical characteristics btw HME and HGA?
HME has possible rash (maculopapular/petechial) and HGA has worse LFTs (both have LFT, leukoepnia, thrombocytopenia)
vector for babesia microti?
reservoir is white footed mouse, tick transmission via ixodes scapularis
Special pearl for babesia microti?
most common cause of blood transfusion related infection in the US?
Treatment for severe babesiosis ?
Quinine 650mg TID + clindamycin 1200mg PO BID for 7-10 days. May require blood transfusion especially for B.Divergens, some B.Microti
treatment for mild-moderate babesiosis?
azithromycin + Atovaquone
Erythema migrans rash outside endemic area?
STARI (midcentral/southcentral US)
Morula blood smear and tick?
if PMN - anaplasma, if monocyte - Ehrlichia
Blood smear with morula with spirochete?
Relapsing fever of borrelia or B.Miyamotoi
Tick with erythrocyte inclusion?
Babesia
