Saturday, February 09, 2008

Myositis with fever and tick borne illnesses

1. Toxoplasmosis causes myosits and hepatitis but usually not high fevers or DIC
2. Lyme disease from deer tick peaks in spring when nymphal forms are feeding. The bites look like blood blisters and may be unnoticed. It occurs in the upper midwest as well as New England.
3. Deer tick also causes human granulocytic ehrlichosis and babesiosis. The former is caused by the lone star tick which is seen in the southern US and not New England. Babesiosis usually causes anemia, and is worse among patients who are old or immunosuppressed or asplenic.
4. The dog tick or wood tick transmits Rocky Mountain spotted fever and tularemia. RMSF causes a vasculitis with headache and a rash. Tick borne tularemia causes an ulceroglandular disease then an eschar and lymphadenopathy.
5. The ornithodoros tick transmits relapsing fever but again not in New England.

Ehrlichosis has a 7-10 day incubation period, multiorgan involvement, HA, myalgias and malaise, with mortality of 1-10 percent. Patients may have (less than 50 %) n/v/d/cough/stiff neck and mental status changes. They may have pancytopenia,a left shift, lymphocytosis, and elevated transaminases. It DOES NOT RESPOND TO MOST ANTIBIOTICS OTHER THAN DOXYCYCLINE

1 comment:

Rick L. said...

Re: "Lyme disease from deer tick peaks in spring when nymphal forms are feeding. The bites look like blood blisters and may be unnoticed. It occurs in the upper midwest as well as New England."

CDC documents cases all over the United States. Hardly a bit of minutiae for you to overlook.

Also, you might find that the range of the lone-star tick has expanded quite a bit over the years.

We see them in my area of southern New England at least.

I'm not a medical professional.