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==Differentiating Tularemia from other Tick-borne diseases==
==Differentiating Tularemia from other Tick-borne diseases==
The following table differentiates between variations of tularemia and their associated manifestations.  
The following table differentiates between variations of tularemia and their associated manifestations. <ref name="Signs Sym">Centers for Disease Control and Prevention, Signs and Symptoms of Tularemia. http://www.cdc.gov/tularemia/signssymptoms/index.html Accessed March 1, 2016 </ref>
 
{| style="font-size: 85%;"
{| style="font-size: 85%;"
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Clinical Manifestation}}
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Clinical Manifestation}}
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|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Glandular tissue|Glandular]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Glandular tissue|Glandular]]
| style="background: #DCDCDC; padding: 5px;" | Resemble clinical manifestations of Ulceroglandular infection without the presence of a skin ulcer.  
| style="background: #DCDCDC; padding: 5px;" | Resemble clinical manifestations of Ulceroglandular infection without the presence of a skin [[Ulcer|ulcer.]]
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Oculoglandular
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Oculoglandular
| style="background: #DCDCDC; padding: 5px;" | Irritation and inflammation of the eye with swelling of lymph glands.  
| style="background: #DCDCDC; padding: 5px;" | Irritation and inflammation of the eye with swelling of [[lymph glands]].  
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Pneumonic and [[Typhoid|Typhoidal]]  
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Pneumonic and [[Typhoid|Typhoidal]]  
| style="background: #DCDCDC; padding: 5px;" | Most dangerous form of tularemia. Characterized by [[cough]], [[chest pain]], and [[breathing difficulties]]. May also include all general flu like [[Symptom|symptoms]], without localization symptoms.   
| style="background: #DCDCDC; padding: 5px;" | Most dangerous form of tularemia. Characterized by [[cough]], [[chest pain]], and [[breathing difficulties]]. May also include all general flu like [[Symptom|symptoms]], without localization symptoms.   
|-
|-
|} <ref name="Signs Sym">Centers for Disease Control and Prevention, Signs and Symptoms of Tularemia. http://www.cdc.gov/tularemia/signssymptoms/index.html Accessed March 1, 2016 </ref>
|}  
 
 
The following table differentiates between general symptoms associated with tularemia and other similarly presenting, tick borne diseases.  
The following table differentiates between general symptoms associated with tularemia and other similarly presenting, tick borne diseases.  
{| style="font-size: 85%;"
{| style="font-size: 85%;"
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Disease}}
! style="width: 80px; background: #4479BA; text-align: center;" colspan="2" |{{fontcolor|#FFF|Disease}}
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Organism}}
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Vector}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Symptoms}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Symptoms}}
|-
|-
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="5d" | {{fontcolor|#FFF|'''Bacterial Infection'''}}
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Bacterial Infection'''}}
|
|
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Borreliosis (Lyme Disease)'' <ref name="Lyme CDC”">Lyme Disease Information for HealthCare Professionals. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/lyme/healthcare/index.html Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Borreliosis]] ([[Lyme disease|Lyme Disease]])'' <ref name="Lyme CDC”">Lyme Disease Information for HealthCare Professionals. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/lyme/healthcare/index.html Accessed on December 30, 2015</ref>
| style="background: #DCDCDC; padding: 5px;" |Flu-like illness, fatigue, fever, arthritis, neuroborreliosis, cranial nerve palsy, carditis and erythema migrans.
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Borrelia burgdorferi]]'' sensu lato complex and ''[[Borrelia mayonii|B. mayonii]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[I. scapularis]]'', ''[[I. pacificus]]'', ''[[I. ricinus]]'', and ''I. persulcatus''
| style="background: #DCDCDC; padding: 5px;" |[[Erythema migrans]], flu-like illness([[fatigue]], [[fever]]), [[Lyme arthritis]], [[neuroborreliosis]], and [[carditis]].
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Relapsing Fever'' <ref name="TBRF CDC”">Relapsing Fever Information. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" rowspan="2" | ''[[Relapsing Fever]]'' <ref name="TBRF CDC”">Relapsing Fever Information. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015</ref>
| style="background: #DCDCDC; padding: 5px;" |Consistently documented high fevers, flu-like illness, headaches, muscular soreness or joint pain, altered mental state, painful urination, rash, and rigors.
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Tick-borne relapsing fever (TBRF):
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Borrelia duttoni'', ''Borrelia hermsii'', and ''Borrelia parkerii''
| style="background: #F5F5F5; padding: 5px; text-align: center;" |''Ornithodoros'' species
| style="background: #DCDCDC; padding: 5px;" rowspan="2" | Consistently documented high [[fevers]], flu-like illness, [[headaches]], [[myalgia|muscular soreness]] or [[joint pain]], [[altered mental status]], [[painful urination]], [[rash]], and [[rigors]].
|-
|-
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="5d" | {{fontcolor|#FFF|'''Typhus (Rickettsia)'''}}
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Louse-borne relapsing fever (LBRF) :
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Borrelia recurrentis]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" |''[[Pediculus humanus]]''
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Rocky Mountain Spotted Fever''
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Typhus (Rickettsia)'''}}
| style="background: #DCDCDC; padding: 5px;" | Fever, alterations in mental state, myalgia, rash, and headaches.
|  
|  
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Helvetica Spotted Fever'' <ref name="RMSF CDC”">Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/rmsf/  Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Rocky Mountain Spotted Fever]]''
| style="background: #DCDCDC; padding: 5px;" | Rash: spotted, red dots. Respiratory symptoms (dyspnea, cough), muscle pain, and headaches.
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Rickettsia rickettsii]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Dermacentor variabilis]]'', [[Dermacentor andersoni]]
| style="background: #DCDCDC; padding: 5px;" | [[Fever]], [[altered mental status]], [[myalgia]], [[rash]], and [[headaches]].
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Ehrlichiosis Anaplasmosis'' <ref name="Ehrlichiosis CDC”">Disease index General  Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Helvetica Spotted Fever]]'' <ref name="RMSF CDC”">Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015</ref>
| style="background: #DCDCDC; padding: 5px;" | Fever, headache, chills, malaise, muscle pain, nausea, confusion, conjunctivitis, or rash (60% in children and 30% in adults).  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Rickettsia helvetica''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ixodes ricinus]]''
| style="background: #DCDCDC; padding: 5px;" | [[Rash]]: spotted, red dots. Respiratory symptoms ([[dyspnea]], [[cough]]), [[myalgia|muscle pain]], and [[headaches]].
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Tularemia'' <ref name="Tulameria CDC”">Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Ehrlichiosis Anaplasmosis|Ehrlichiosis (Anaplasmosis)]]'' <ref name="Ehrlichiosis CDC”">Disease index General  Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref>
| style="background: #DCDCDC; padding: 5px;" | Ulceroglandular, Glandular, Oculoglandular, Oroglandular, Pneumonic, Typhoidal.  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Ehrlichia chaffeensis, Ehrlichia ewingii''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Amblyomma americanum]], [[Ixodes scapularis]]''
| style="background: #DCDCDC; padding: 5px;" | [[Fever]], [[headache]], [[chills]], [[malaise]], [[myalgia|muscle pain]], [[nausea]], [[confusion]], [[conjunctivitis]], or [[rash]] (60% in children and 30% in adults).  
|-
|-
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="5d" | {{fontcolor|#FFF|'''Viral Infection'''}}
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Tularemia]]'' <ref name="Tulameria CDC”">Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015).  \http://www.cdc.gov/tularemia/index.html  Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Francisella tularensis]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Dermacentor andersoni|''Dermacentor andersoni'']]'', [[Dermacentor variabilis]]''
| style="background: #DCDCDC; padding: 5px;" | Ulceroglandular, [[glandular]], oculoglandular, oroglandular, pneumonic, typhoidal.
|-
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Viral Infection'''}}
|
|
|-  
|-  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | Tick-borne meningoencephalitis <ref name="TBE CDC”">General Disease Information (TBE). Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | Tick-borne [[meningoencephalitis]] <ref name="TBE CDC”">General Disease Information (TBE). Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015</ref>
| style="background: #DCDCDC; padding: 5px;" | Early Phase: Non-specific symptoms including fever, malaise, anorexia, muscle pains, headaches, nausea, and vomiting. Second Phase: Meningitis symptoms, headache, stiff neck, encephalitis, drowsiness, sensory disturbances, and potential paralysis.  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''TBEV virus''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ixodes scapularis]]'', ''[[I. ricinus]]'', ''I. persulcatus''
| style="background: #DCDCDC; padding: 5px;" | Early Phase: Non-specific symptoms including [[fever]], [[malaise]], [[anorexia]], [[myalgia|muscle pains]], [[headaches]], [[nausea]], and [[vomiting]]. Second Phase: [[Meningitis]] symptoms, [[headache]], [[stiff neck]], [[encephalitis]], [[drowsiness]], sensory disturbances, and potential [[paralysis]].  
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | Colorado Tick Fever <ref name="GenTickDis CDC”">General Tick Deisease Information. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | [[Colorado tick fever|Colorado Tick Fever]] <ref name="GenTickDis CDC”">General Tick Deisease Information. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015</ref>
| style="background: #DCDCDC; padding: 5px;" |Common symptoms include fever, chills, headache, body aches, and lethargy. Other symptoms associated with the disease include sore throat, abdominal pain, vomiting, and a skin rash. A biphasic fever is a hallmark of Colorado Tick Fever and presents itself in nearly 50% of infected patients.  
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''CTF virus''
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[Dermacentor andersoni]]''
| style="background: #DCDCDC; padding: 5px;" |Common symptoms include [[fever]], [[chills]], [[headache]], [[body aches]], and [[lethargy]]. Other symptoms associated with the disease include [[sore throat]], [[abdominal pain]], [[vomiting]], and a skin [[rash]]. A biphasic [[fever]] is a hallmark of Colorado Tick Fever and presents in nearly 50% of infected patients.  
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | Crimean-Congo Hemorrhagic Fever
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | [[Crimean-Congo Hemmoragic Fever|Crimean-Congo Hemorrhagic Fever]]
| style="background: #DCDCDC; padding: 5px;" |Initially infected patients will likely feel a few of the following symptoms; headache, high fever, back and joint pain, stomach pain, vomiting, flushed face, red throat petechiae of the palate, and potentially changes in mood as well as sensory perception.  
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[CCHF virus]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  '' Hyalomma marginatum'', ''Rhipicephalus bursa''
| style="background: #DCDCDC; padding: 5px;" |Initially infected patients will likely feel a few of the following symptoms: [[headache]], high [[fever]], [[back pain|back]] and [[joint pain]], [[stomach pain]], [[vomiting]], flushed face, red throat [[petechiae]] of the [[palate]], and potentially changes in mood as well as sensory perception.  
|-
|-
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="5d" | {{fontcolor|#FFF|'''Protozoan Infection'''}}
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Protozoan Infection'''}}
|
|
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | Babesiosis <ref name="Babesiosis CDC”">Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | [[Babesiosis]] <ref name="Babesiosis CDC”">Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.</ref>
| style="background: #DCDCDC; padding: 5px;" |Non-specific flu like symptoms.
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[Babesia microti]], [[Babesia divergens]], Babesia equi''
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[Ixodes scapularis]],  ''[[I. pacificus]]
 
| style="background: #DCDCDC; padding: 5px;" |Non-specific flu-like symptoms.
|}
|}


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[[Category:Zoonoses]]
[[Category:Zoonoses]]
[[Category:Biological weapons]]
[[Category:Biological weapons]]
[[Category:Infectious disease]]

Latest revision as of 19:03, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.

Overview

General symptoms reported within the early stages tularemia often resemble those of other tick-borne diseases. These symptoms include fever, chills, headache, and other non-specific flu like symptoms. Later stages of tularemia may include pneumonic clinical manifestations and ulcers in the epidermal tissue.[1]

Differentiating Tularemia from other Tick-borne diseases

The following table differentiates between variations of tularemia and their associated manifestations. [1]

Clinical Manifestation Transmission
Ulceroglandular Skin ulcer forms as the site of infection as well as general flu like symptoms and swelling of regional lymph glands.
Glandular Resemble clinical manifestations of Ulceroglandular infection without the presence of a skin ulcer.
Oculoglandular Irritation and inflammation of the eye with swelling of lymph glands.
Pneumonic and Typhoidal Most dangerous form of tularemia. Characterized by cough, chest pain, and breathing difficulties. May also include all general flu like symptoms, without localization symptoms.

The following table differentiates between general symptoms associated with tularemia and other similarly presenting, tick borne diseases.

Disease Organism Vector Symptoms
Bacterial Infection
Borreliosis (Lyme Disease) [2] Borrelia burgdorferi sensu lato complex and B. mayonii I. scapularis, I. pacificus, I. ricinus, and I. persulcatus Erythema migrans, flu-like illness(fatigue, fever), Lyme arthritis, neuroborreliosis, and carditis.
Relapsing Fever [3] Tick-borne relapsing fever (TBRF): Borrelia duttoni, Borrelia hermsii, and Borrelia parkerii Ornithodoros species Consistently documented high fevers, flu-like illness, headaches, muscular soreness or joint pain, altered mental status, painful urination, rash, and rigors.
Louse-borne relapsing fever (LBRF) : Borrelia recurrentis Pediculus humanus
Typhus (Rickettsia)
Rocky Mountain Spotted Fever Rickettsia rickettsii Dermacentor variabilis, Dermacentor andersoni Fever, altered mental status, myalgia, rash, and headaches.
Helvetica Spotted Fever [4] Rickettsia helvetica Ixodes ricinus Rash: spotted, red dots. Respiratory symptoms (dyspnea, cough), muscle pain, and headaches.
Ehrlichiosis (Anaplasmosis) [5] Ehrlichia chaffeensis, Ehrlichia ewingii Amblyomma americanum, Ixodes scapularis Fever, headache, chills, malaise, muscle pain, nausea, confusion, conjunctivitis, or rash (60% in children and 30% in adults).
Tularemia [6] Francisella tularensis Dermacentor andersoni, Dermacentor variabilis Ulceroglandular, glandular, oculoglandular, oroglandular, pneumonic, typhoidal.
Viral Infection
Tick-borne meningoencephalitis [7] TBEV virus Ixodes scapularis, I. ricinus, I. persulcatus Early Phase: Non-specific symptoms including fever, malaise, anorexia, muscle pains, headaches, nausea, and vomiting. Second Phase: Meningitis symptoms, headache, stiff neck, encephalitis, drowsiness, sensory disturbances, and potential paralysis.
Colorado Tick Fever [8] CTF virus Dermacentor andersoni Common symptoms include fever, chills, headache, body aches, and lethargy. Other symptoms associated with the disease include sore throat, abdominal pain, vomiting, and a skin rash. A biphasic fever is a hallmark of Colorado Tick Fever and presents in nearly 50% of infected patients.
Crimean-Congo Hemorrhagic Fever CCHF virus Hyalomma marginatum, Rhipicephalus bursa Initially infected patients will likely feel a few of the following symptoms: headache, high fever, back and joint pain, stomach pain, vomiting, flushed face, red throat petechiae of the palate, and potentially changes in mood as well as sensory perception.
Protozoan Infection
Babesiosis [9] Babesia microti, Babesia divergens, Babesia equi Ixodes scapularis, I. pacificus Non-specific flu-like symptoms.

References

  1. ↑ 1.0 1.1 Centers for Disease Control and Prevention, Signs and Symptoms of Tularemia. http://www.cdc.gov/tularemia/signssymptoms/index.html Accessed March 1, 2016
  2. ↑ Lyme Disease Information for HealthCare Professionals. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/lyme/healthcare/index.html Accessed on December 30, 2015
  3. ↑ Relapsing Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015
  4. ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015
  5. ↑ Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015
  6. ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015
  7. ↑ General Disease Information (TBE). Centers for Disease Control and Prevention (2015). http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015
  8. ↑ General Tick Deisease Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015
  9. ↑ Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.

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