Tick-borne disease
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Overview
Tick-borne diseases are diseases or illnesses transmitted by ticks. As the incidence of tick-borne illnesses increases and the geographic areas in which they are found expand, it becomes increasingly important that health professionals be able to distinguish the diverse, and often overlapping, clinical presentations of these diseases.
Pathophysiology
Tick-borne illnesses are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa. Because ticks can harbor more than one disease-causing agent, patients can be infected with more than one pathogen at the same time, compounding the difficulty in diagnosis and treatment.
Major tick-borne diseases include:
- Lyme disease
- Organism: Borrelia burgdorferi sensu lato (bacterium)
- Vector: deer tick (Ixodes scapularis (=I. dammini), I. pacificus, I. ricinus (Europe), I. persulcatus (Asia))
- Endemic to: North America and Eurasia
- Tick-borne meningoencephalitis
- Organism: TBEV aka FSME virus, a flavivirus
- Vector: deer tick (Ixodes scapularis)
- Endemic to: Europe and Northern Asia
- Rocky Mountain Spotted Fever
- Organism: Rickettsia rickettsii
- Vector: Dermacentor variabilis, D. andersoni
- Region (US): East, South West
- Vector: Amblyomma cajennense
- Region (Brazil): São Paulo, Rio de Janeiro, Minas Gerais.
- Babesiosis
- Organism: Babesia microti, B. equi
- Vector: I. scapularis, I. pacificus
- Region (US): Northeast West Coast
- Ehrlichiosis anaplasmosis (formerly human granulocytic ehrlichiosis or HGE)
- Organism: Ehrlichia chaffeensis, E. equi
- Vector: Amblyomma americanum, I. scapularis
- Region (US): South-Atlantic South-Central
- Relapsing fever
- Organism: Borrelia species
- Vector: Ornithodoros species
- Region (US): West
- Colorado tick fever
- Organism: Coltivirus
- Vector: D. andersoni
- Region (US): West
- Tularemia
- Organism: Francisella tularensis, A. americanum
- Organism: D. andersoni, D. variabilis
- Region (US): Southeast, South-Central, West, Widespread
- Tick paralysis
- Cause: Toxin
- Vector: D. andersoni, D. variabilis West
- Region (US): East
- Cytauxzoonosis
- Organism: C. felis
- Vector: D. variabilis (American Dog Tick)
- Region (US): South, Southeast
Diagnosis
Symptoms
Symptoms can vary in severity and include:
- Fever
- Headache
- Malaise
- Skin rash
- Confusion
- Arthralgias or swelling and pain in the joints
- Shortness of breath
- Palpitations
- Vomiting
Physical examination
A rash with a central black area (eschar)as shown in the photo is suggestive of a tick bite.
Laboratory evaluation
In general, specific laboratory tests are not available to rapidly diagnose tick-borne diseases.
Treatment
Due to their seriousness, antibiotic treatment is often justified based on clinical presentation alone. Doxycycline is often used to treat suspected tick borne-disease.
External links
- eMedicine - Tick-Borne Diseases, Introduction by Jonathan A. Edlow, MD
- Tickborne Diseases - National Center for Infectious Diseases (CDC)
- Tickborne Disease Website - Massachusetts Department of Public Health
- Tick bite fever - Health 24