Ticks

Question 1

scrub typhus

Answer 1

Orientia tsutsugamushi

Question 2

Louse-Borne Relapsing Fever

Answer 2

Borrelia recurrentis

Question 3

tick-borne relapsing fever

Answer 3

Borrelia hermsii

Borrelia tuicatae

Question 4

Boutonneuse fever

Answer 4

Rickettsia conorii

Question 5

Louse-borne epidemic typhus

Answer 5

Ricketsia prowazekii

Question 6

Endemic typhus

Answer 6

Rickettsia typhi

Question 7

Blacklegged tick

Answer 7

Ixodes scapularis; small, Lyme, Anaplasma, Babesia, B myomoti

Question 8

Lone Star tick

Answer 8

Ambylomma americanum; Erlichia, HME

Question 9

Dog tick

Answer 9

Dermacentor variabilis; Ricketttsia

Question 10

American Boutonneuse Fever

Answer 10

Lone Star, Gulf Coast ticks
SW US, gulf coast
Maculatum fever -
HA, myalgias, faint salmon-colored rash with single or multiple eschars
diagnosis: spotted fever group serology, PCR or culture of eschar, immunohistochemistry

Question 11

Pacific Coast Tick fever

Answer 11

Rickettsia philipi
northern baja - southern Oregon
eschar, fever, HA

Question 12

African tick bite fever

Answer 12

Ricketsia africae

Question 13

Rickettsia akari

Answer 13

Rickettsialpox; urban acquisition - bronx!

house mites, single eschar, papulovesicular or maculopapular rash, diagnosis - PCR swab/vesicle; tx is doxycycline

Question 14

scrub typhus

Answer 14

Orientia tsutsugamushi; chigger
Japan-Eastern Australia- Southern Russia
severe - high fever, eschar, painful draining lymph nodes, rash, delirium; MSOF, fatality of 70%, tx with doxycycline

Question 15

epidemic typhus

Answer 15

R prowazekii 
louse - body, head
war refugees, crowded conditions/poor hygiene
lethal 
doxy 
boil clothes, delouse, DDT
Brill-Zinser disease (years-decades)

Question 16

endemic typhus

Answer 16

R typhi
flea - rat, cat
worldwide - US, Southern CA
Mild
Tetracycline, doxycycline, chloramphenicol
flea prevention, domestic animals, reduce rodent population

Question 17

HME (Erlichia)

Answer 17

Erlichia chaffeensis, Lone Star tick. rash in 30%, labs - hepatitis, leukopenia, thrombocytopenia
mortality 2.7%, diagnosis with PCR, morulae, acute/convalescent serology; tx with doxycycline

Question 18

HGA (Anaplasma)

Answer 18

Anaplasma phagocytophilum; Ixodes scapularis
rare rash, LFTs, leukopenia,
mortality 0.3 - 0.7%
diagnosis - same as HME

Question 19

Babesia microti

Answer 19

common in US where Lyme is;
intra-erythrocytic, very ill, cytopenias, parasitemias with severe disease, mortality above 20%, serology can be elevated
use atovaquoune and azithromycin for severe and mild-mod severity cases

Question 20

Tickborne relapsing fever

Answer 20

Borrelia spp - B hermsii
- soft ticks
Western states. - cabins, rustic houses, rodents, at specific elevations
clinical - fever, relapsing, HA, myalgia, N,V - can be severe lead to ARDS
labs - AKI, decreased platelets
PCN, doxy, can get JH reaction

Question 21

Louse-Borne relapsing fever

Answer 21

Borrelia recurrentis; human body louse, refugee camps, famine, natural disasters
more severe, tx with doxy

Question 22

B miyamotoi

Answer 22

Ixodes tick, unclear vector
same epidemio as Lyme
similar to HGA
  - meningoencephalitis in comrpromised hosts
diagnosis - blood smear, PCR, serology
tx is similar to Lyme

Question 23

B mayonii

Answer 23

acute febrile illness with rash

Minnesota and Wisconsin

Question 24

Heartland virus

Answer 24

Missouri, TN

think about if not responding to doxycyline