RESUMEN
The third Ehrlichia infection described in humans in the United States is reviewed. This rare zoonosis was first published in 1999. This case report that expands the clinical paradigm is described. A 57-year-old immunocompetent adult, unlike previously published reports, did not cross react with Ehrlichia chaffeensis.
Asunto(s)
Ehrlichiosis/inmunología , Antibacterianos/uso terapéutico , Antígenos Bacterianos/análisis , Reacciones Cruzadas , Doxiciclina/uso terapéutico , Ehrlichiosis/diagnóstico , Humanos , Inmunocompetencia , Masculino , Persona de Mediana Edad , Reacción en Cadena de la PolimerasaRESUMEN
Lyme-like illness (also known as southern tick-associated rash illness [STARI] or Masters disease) is vectored by the Lone Star tick (Amblyomma americanum). Lyme-like illness lesions, which are similar to the erythema migrans rash of Lyme disease, tend to have lymphocytic dermal infiltrates. With the exception of Borrelia lonestari, the possible causative agent or agents of Lyme-like illness have not been cultured. More research is needed to fully understand this newly recognized zoonosis. Clinicians are encouraged to increase their knowledge and awareness of this Lyme disease mimic.
Asunto(s)
Vectores Arácnidos/microbiología , Infecciones por Borrelia , Ixodidae/microbiología , Enfermedades por Picaduras de Garrapatas , Animales , Infecciones por Borrelia/diagnóstico , Infecciones por Borrelia/tratamiento farmacológico , Infecciones por Borrelia/epidemiología , Infecciones por Borrelia/microbiología , Eritema Crónico Migrans/diagnóstico , Eritema Crónico Migrans/tratamiento farmacológico , Eritema Crónico Migrans/epidemiología , Eritema Crónico Migrans/microbiología , Humanos , Enfermedades por Picaduras de Garrapatas/diagnóstico , Enfermedades por Picaduras de Garrapatas/tratamiento farmacológico , Enfermedades por Picaduras de Garrapatas/epidemiología , Enfermedades por Picaduras de Garrapatas/microbiología , Estados Unidos/epidemiologíaAsunto(s)
Antibacterianos/uso terapéutico , Enfermedad de Lyme/tratamiento farmacológico , Enfermedad de Lyme/microbiología , Enfermedades por Picaduras de Garrapatas/tratamiento farmacológico , Enfermedades por Picaduras de Garrapatas/microbiología , Humanos , Enfermedad de Lyme/complicaciones , Miocarditis/etiología , Enfermedades por Picaduras de Garrapatas/complicacionesRESUMEN
OBJECTIVE: To determine responses of Borrelia lonestari and Borrelia burgdorferi to Eastern Fence lizard (Sceloporus undulatus) and Swiss-Webster mouse (Mus musculus) sera. RESULTS: Lizard sera lysed both Borrelia lonestari and Borrelia burgdorferi. Mouse sera lysed only Borrelia lonestari. CONCLUSIONS: Borrelia lonestari and Borrelia burgdorferi spirochetes did not survive exposure to lizard sera. Mice are reservoirs for Borrelia burgdorferi but may not be a Borrelia lonestari reservoir because spirochetes did not survive exposure to mouse sera.
Asunto(s)
Borrelia/fisiología , Lagartos/sangre , Ratones/sangre , Animales , Bacteriólisis/fisiología , Borrelia burgdorferi/fisiología , Grupo Borrelia Burgdorferi/fisiología , Enfermedad de Lyme/microbiología , MissouriRESUMEN
Rocky Mountain spotted fever is still the most lethal tick-vectored illness in the United States. We examine the dilemmas facing the clinician who is evaluating the patient with possible Rocky Mountain spotted fever, with particular attention to the following 8 pitfalls in diagnosis and treatment: (1) waiting for a petechial rash to develop before diagnosis; (2) misdiagnosing as gastroenteritis; (3) discounting a diagnosis when there is no history of a tick bite; (4) using an inappropriate geographic exclusion; (5) using an inappropriate seasonal exclusion; (6) failing to treat on clinical suspicion; (7) failing to elicit an appropriate history; and (8) failing to treat with doxycycline. Early diagnosis and proper treatment save lives.
Asunto(s)
Fiebre Maculosa de las Montañas Rocosas , Antibacterianos/administración & dosificación , Niño , Preescolar , Diagnóstico Diferencial , Errores Diagnósticos , Doxiciclina/administración & dosificación , Femenino , Humanos , Fiebre Maculosa de las Montañas Rocosas/diagnóstico , Fiebre Maculosa de las Montañas Rocosas/tratamiento farmacológico , Fiebre Maculosa de las Montañas Rocosas/epidemiología , Estados Unidos/epidemiologíaRESUMEN
Preview Because disseminated Lyme disease can be devastating, early recognition and treatment are important. The presence of erythema migrans offers the best opportunity for early diagnosis. Therefore, public awareness and patient education about the rash of Lyme disease are critical. Dr Masters gives practical pointers from his own experience in evaluation of erythema migrans and reviews current treatment recommendations.