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Rocky Mountain Spotted Fever HELP
Based on 245 articles published since 2010

These are the 245 published articles about Rocky Mountain Spotted Fever that originated from Worldwide during 2010-2020.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10
1 Guideline Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States. 2016

Biggs, Holly M / Behravesh, Casey Barton / Bradley, Kristy K / Dahlgren, F Scott / Drexler, Naomi A / Dumler, J Stephen / Folk, Scott M / Kato, Cecilia Y / Lash, R Ryan / Levin, Michael L / Massung, Robert F / Nadelman, Robert B / Nicholson, William L / Paddock, Christopher D / Pritt, Bobbi S / Traeger, Marc S. ·National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia. ·MMWR Recomm Rep · Pubmed #27172113.

ABSTRACT: Tickborne rickettsial diseases continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of low-cost, effective antibacterial therapy. Recognition early in the clinical course is critical because this is the period when antibacterial therapy is most effective. Early signs and symptoms of these illnesses are nonspecific or mimic other illnesses, which can make diagnosis challenging. Previously undescribed tickborne rickettsial diseases continue to be recognized, and since 2004, three additional agents have been described as causes of human disease in the United States: Rickettsia parkeri, Ehrlichia muris-like agent, and Rickettsia species 364D. This report updates the 2006 CDC recommendations on the diagnosis and management of tickborne rickettsial diseases in the United States and includes information on the practical aspects of epidemiology, clinical assessment, treatment, laboratory diagnosis, and prevention of tickborne rickettsial diseases. The CDC Rickettsial Zoonoses Branch, in consultation with external clinical and academic specialists and public health professionals, developed this report to assist health care providers and public health professionals to 1) recognize key epidemiologic features and clinical manifestations of tickborne rickettsial diseases, 2) recognize that doxycycline is the treatment of choice for suspected tickborne rickettsial diseases in adults and children, 3) understand that early empiric antibacterial therapy can prevent severe disease and death, 4) request the appropriate confirmatory diagnostic tests and understand their usefulness and limitations, and 5) report probable and confirmed cases of tickborne rickettsial diseases to public health authorities.

2 Review Rickettsial infections of the central nervous system. 2019

Sekeyová, Zuzana / Danchenko, Monika / Filipčík, Peter / Fournier, Pierre Edouard. ·Institute of Virology, Slovak Academy of Sciences, Dubravska cesta, Bratislava, Slovakia. · Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta, Bratislava, Slovakia. · Aix-Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU Mediterranée-Infection, Marseille, France. · Centre National de Référence des Rickettsia, Coxiella et Bartonella, IHU Mediterranée-Infection, Marseille, France. ·PLoS Negl Trop Dis · Pubmed #31465452.

ABSTRACT: As a result of migrations and globalization, people may face a possible increase in the incidence of central nervous system rickettsial infections (CNS R). These diseases, caused by Rickettsia species and transmitted to humans by arthropod bites, are putatively lethal. However, the diagnosis of CNS R is challenging and often delayed due to their nonspecific clinical presentation and the strict intracellular nature of rickettsiae. Furthermore, transfer of rickettsiae to the brain parenchyma is not yet understood. The aim of this review is to analyze and summarize the features and correlated findings of CNS R in order to focus attention on these intriguing but frequently neglected illnesses. We also incorporated data on CNS infections caused by Rickettsia-related microorganisms.

3 Review The Rickettsioses: A Practical Update. 2019

Blanton, Lucas S. ·Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0435, USA. Electronic address: lsblanto@utmb.edu. ·Infect Dis Clin North Am · Pubmed #30712763.

ABSTRACT: Rickettsia are small, obligately intracellular, gram-negative bacilli. They are distributed among a variety of hematophagous arthropod vectors and cause illness throughout the world. Rickettsioses present as an acute undifferentiated febrile illness and are often accompanied by headache, myalgias, and malaise. Cutaneous manifestations include rash and eschar, which both occur at varying incidence depending on the infecting species. Serology is the mainstay of diagnosis, and the indirect immunofluorescence assay is the test of choice. Reactive antibodies are seldom present during early illness, so testing should be performed on both acute-phase and convalescent-phase sera. Doxycycline is the treatment of choice.

4 Review A review of the genus 2018

Bermúdez, C Sergio E / Troyo, Adriana. ·Department of Medical Entomology, Gorgas Memorial Institute for Health Research, Panamá, sbermudez@gorgas.gob.pa. · Vector Research Laboratory, Tropical Diseases Research Center, Faculty of Microbiology, University of Costa Rica, San Jose, Costa Rica. ·Res Rep Trop Med · Pubmed #30050361.

ABSTRACT: In this paper, we present a historical review of rickettsiosis in Central America and also the most recent findings of

5 Review The Evaluation and Management of Rocky Mountain Spotted Fever in the Emergency Department: a Review of the Literature. 2018

Gottlieb, Michael / Long, Brit / Koyfman, Alex. ·Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois. · Department of Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas. · Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas. ·J Emerg Med · Pubmed #29685474.

ABSTRACT: BACKGROUND: Rocky Mountain spotted fever (RMSF) is potentially deadly and can present subtly with signs and symptoms overlapping with other clinical conditions. Delayed diagnosis can be fatal. OBJECTIVE: This review provides an evidence-based summary of the current data for the evaluation and management of RMSF in the emergency department. DISCUSSION: RMSF occurs through transmission of Rickettsia rickettsii by an infected tick. Exposure in the United States occurs most commonly from April to September, and high-risk locations include wooded, shrubby, or grassy areas. Approximately half of patients with infection do not recall tick exposure. Symptoms can include fever, headache, photophobia, malaise, myalgias, and a petechial rash that begins on the wrists and ankles and spreads to the trunk. Rash may not occur in ≤15% of patients, and the classic triad of fever, headache, and rash is also not definitive. Laboratory evaluation may demonstrate hyponatremia, anemia, thrombocytopenia, abnormal liver enzymes, and elevated coagulation tests. Antibody testing can be helpful, but these results are not typically available to the emergency clinician. Doxycycline is the treatment of choice in adults, children, and pregnant patients. Patients should be advised about prevention strategies and effective techniques for removing ticks. CONCLUSIONS: RMSF is a potentially deadly disease that requires prompt recognition and management. Focused history, physical examination, and testing are important in the diagnosis of this disease. Understanding the clinical features, diagnostic tools, and proper treatment can assist emergency clinicians in the management of RMSF.

6 Review Tick borne illness - Rocky mountain spotted fever. 2018

McFee, Robin B. ·Department of Emergency/Family Medicine, Debusk College of Osteopathic Medicine, Lincoln Memorial University, USA. Electronic address: drrbmcfee@gmail.com. ·Dis Mon · Pubmed #29549965.

ABSTRACT: -- No abstract --


McFee, Robin B. ·Debusk College of Osteopathic Medicine, Lincoln Memorial University. Electronic address: tweetydoctor@aol.com. ·Dis Mon · Pubmed #29525372.

ABSTRACT: -- No abstract --

8 Review Molecular diagnosis of skin infections using paraffin-embedded tissue - review and interdisciplinary consensus. 2018

Sunderkötter, Cord / Becker, Karsten / Kutzner, Heinz / Meyer, Thomas / Blödorn-Schlicht, Norbert / Reischl, Udo / Nenoff, Pietro / Geißdörfer, Walter / Gräser, Yvonne / Herrmann, Mathias / Kühn, Joachim / Bogdan, Christian. ·Department of Translational Dermatoinfectiology, Westphalian Wilhelms University, Münster, Germany, and Department of Dermatology and Venereology, University Medical Center, Martin Luther University Halle-Wittenberg, Halle, Germany. · Institute of Medical Microbiology, University Medical Center, Münster, Germany. · Dermatopathology Friedrichshafen, Germany. · Institute for Medical Microbiology, Virology, and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Dermatologikum Hamburg GmbH, Hamburg, Germany. · Institute of Clinical Microbiology and Hygiene, University Medical Center, Regensburg, Germany. · Laboratory of Medical Microbiology, Rötha OT Mölbis, Germany. · Microbiology Institute - Clinical Microbiology, Immunology, and Hygiene, University Medical Center, Erlangen, Germany. · Institute of Microbiology and Hygiene, University Medicine Berlin - Charite, Berlin, Germany. · Institute of Medical Microbiology and Hygiene Institute for Infectious Diseases, Saarland University Medical Center, now: Dean of the Medical Faculty, Westphalian Wilhelms University, Münster, Germany. · Institute of Virology, University Medical Center, Münster, Germany. · Institute of Microbiology - Clinical Microbiology, Immunology, and Hygiene, University Medical Center and Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany. ·J Dtsch Dermatol Ges · Pubmed #29418086.

ABSTRACT: Nucleic acid amplification techniques (NATs), such as PCR, are highly sensitive and specific methods that have become valuable supplements to culture and serology in the diagnosis of infectious disorders. However, especially when using formalin-fixed and paraffin-embedded tissue, these techniques are associated with both false-negative and false-positive results, a pitfall that is frequently misjudged. Representatives of the German Society of Hygiene and Microbiology (DGHM) and the German Society of Dermatology (DDG) therefore set out to develop a consensus - in the form of a review article - on the appropriate indications for NATs using paraffin-embedded tissue, its contraindications, and the key points to be considered in the pre- and post-analytical phase. Given that fresh, naive tissue is preferably to be used in the workup of a suspected infection, PCR analysis on paraffin sections represents an exception. The latter may be considered if an infection is suspected at a later point in time and fresh tissue has not been preserved or can no longer be obtained. Potential indications include confirmation of histologically suspected infections with Leishmania spp., Bartonella spp., Rickettsia spp., or in case of ecthyma contagiosum. Infections with, for example, mycobacteria or RNA viruses, on the other hand, are not considered useful indications for NATs using paraffin sections. In order to avoid misinterpretation of test results, it is essential that laboratory reports on NATs using paraffin-embedded tissue contain information on the indication/diagnostic circumstances, the required and chosen pre-analytical steps, the limitations of the method, and on diagnostic alternatives.

9 Review Tick Talk: Tick-borne Diseases of South Dakota. 2017

Huntington, Mark K / Allison, Jay. ·Center for Family Medicine. · Department of Family Medicine, University of South Dakota Sanford School of Medicine. ·S D Med · Pubmed #28863253.

ABSTRACT: In addition to being a nuisance, ticks can carry disease. This article presents a brief review of ticks and associated tick-borne disease relevant to South Dakota and surrounding regions. Tick-borne diseases of special relevance in South Dakota include tularemia, Rocky Mountain spotted fever, and Lyme disease. A number of others may also be encountered in the state as well. Prompt treatment of suspected cases is important to ensure a successful recovery, and tick-avoidance measures can reduce the risks of acquiring them. Most of these conditions are nationally reportable infectious diseases.

10 Review Rocky Mountain spotted fever in Mexico: past, present, and future. 2017

Álvarez-Hernández, Gerardo / Roldán, Jesús Felipe González / Milan, Néstor Saúl Hernández / Lash, R Ryan / Behravesh, Casey Barton / Paddock, Christopher D. ·Department of Medicine and Health Sciences, University of Sonora, Hermosillo, Sonora, Mexico. Electronic address: galvarezh63@gmail.com. · National Center for Preventive Programs and Disease Control, Mexico City, Mexico. · Department of Epidemiology, Institute of Public Health Services of the State of Baja California, Mexicali, Baja California, Mexico. · National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. ·Lancet Infect Dis · Pubmed #28365226.

ABSTRACT: Rocky Mountain spotted fever, a tick-borne zoonosis caused by Rickettsia rickettsii, is among the most lethal of all infectious diseases in the Americas. In Mexico, the disease was first described during the early 1940s by scientists who carefully documented specific environmental determinants responsible for devastating outbreaks in several communities in the states of Sinaloa, Sonora, Durango, and Coahuila. These investigators also described the pivotal roles of domesticated dogs and Rhipicephalus sanguineus sensu lato (brown dog ticks) as drivers of epidemic levels of Rocky Mountain spotted fever. After several decades of quiescence, the disease re-emerged in Sonora and Baja California during the early 21st century, driven by the same environmental circumstances that perpetuated outbreaks in Mexico during the 1940s. This Review explores the history of Rocky Mountain spotted fever in Mexico, current epidemiology, and the multiple clinical, economic, and social challenges that must be considered in the control and prevention of this life-threatening illness.

11 Review Rocky Mountain Spotted Fever. 2017

Phillips, Jennan. ·1 University of Alabama at Birmingham. ·Workplace Health Saf · Pubmed #28055518.

ABSTRACT: The tick-borne disease Rocky Mountain spotted fever (RMSF) can have deadly outcomes unless treated appropriately, yet nonspecific flu-like symptoms complicate diagnosis. Occupational health nurses must have a high index of suspicion with symptomatic workers and recognize that recent recreational or occupational activities with potential tick exposure may suggest RMSF.

12 Review The eye and tick-borne disease in the United States. 2016

Sathiamoorthi, Saraniya / Smith, Wendy M. ·aMayo Medical School bDepartment of Ophthalmology cMayo Clinic, Rochester, Minnesota, USA. ·Curr Opin Ophthalmol · Pubmed #27585218.

ABSTRACT: PURPOSE OF REVIEW: Tick-borne diseases are increasing in incidence and geographic distribution. Several diseases endemic to the United States have ophthalmic manifestations, including the most common tick-borne disease, Lyme borreliosis. As ocular complaints may lead a patient to seek medical evaluation, it is important to be aware of the systemic and ophthalmic manifestations of tick-borne diseases in order to make the correct diagnosis. RECENT FINDINGS: Vision-threatening ophthalmic manifestations are relatively common in Lyme disease and Rocky Mountain spotted fever. Ocular involvement is rare in babesiosis, tick-borne relapsing fever, Powassan encephalitis, ehrlichiosis, anaplasmosis, and Colorado tick fever.There are clear guidelines for diagnosis and treatment of Lyme disease; however, confusion and misinformation among the general public as well as controversy about chronic or late-stage Lyme disease can impact the evaluation of ophthalmic disease. Furthermore, there are many gaps in our knowledge regarding the pathophysiology of ocular borreliosis although it seems likely that Lyme uveitis is rare in the United States. SUMMARY: Knowledge of systemic and ophthalmic manifestations combined with an understanding of the epidemiology of disease vectors is crucial for the diagnosis of tick-borne diseases.

13 Review Ocular manifestations of tick-borne diseases. 2016

Raja, Harish / Starr, Matthew R / Bakri, Sophie J. ·Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA. · Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: bakri.sophie@mayo.edu. ·Surv Ophthalmol · Pubmed #27060746.

ABSTRACT: Tick-borne illnesses are a significant disease burden worldwide. Diagnosis is challenging and requires a high level of clinical suspicion. Ocular manifestations reported in association with tick-borne disease are mostly as case reports and small case series because of the relative infrequency with which they occur; however, given the global nature of health care and increase in travel in the 21st century, it is important for ophthalmologists to be aware of ocular manifestations of these diseases because early diagnosis may reduce morbidity and mortality. Here, we review of the literature of tick-borne diseases with reported ophthalmic findings. All known human tick-borne diseases are discussed, including a brief description of the causative agent, region of endemicity, vector, systemic symptoms, and any reported eye findings. When possible, we also address the strength of the evidence for these ocular associations.

14 Review Tick-Borne Illnesses. 2016

Choi, Edwin / Pyzocha, Natasha J / Maurer, Douglas M. ·Madigan Army Medical Center, Department of Family Medicine, Fort Lewis, WA. ·Curr Sports Med Rep · Pubmed #26963018.

ABSTRACT: Tick-borne diseases are prevalent throughout the United States. These illnesses are caused by a variety of different pathogens that use ticks as vectors, including bacteria, viruses, rickettsia, and protozoa. Some of the most common illnesses caused by ticks are Lyme disease, Rocky Mountain spotted fever, babesiosis, ehrlichiosis, anaplasmosis, tularemia, Colorado tick fever, tick-borne relapsing fever, and Powassan disease. Unique skin changes, fever, and influenza-like symptoms may indicate tick-borne disease. Early diagnosis can be difficult as well as nonspecific and can resemble overtraining syndrome. Diagnosis is important to facilitate early treatment to decrease morbidity and mortality and should often be initiated before a definitive diagnosis is made. Treatment guidelines are published by the Centers for Disease Control and Prevention. As tick-borne diseases increase and their geographic regions expand, it is important for providers to distinguish the often overlapping and diverse presentations of these diseases.

15 Review Recognition of and Prompt Treatment for Tick-Borne Infections in Children. 2015

Mukkada, Sheena / Buckingham, Steven C. ·Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee College of Medicine, 50 North Dunlap Street, Memphis, TN 38103, USA; Department of Infectious Diseases, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA. · Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee College of Medicine, 50 North Dunlap Street, Memphis, TN 38103, USA. Electronic address: sbucking@uthsc.edu. ·Infect Dis Clin North Am · Pubmed #26188606.

ABSTRACT: Tick-borne infections create diagnostic challenges because they tend to present with nonspecific findings. Because clinicians often fail to recognize tick-borne illnesses in early stages, therapy is frequently delayed or omitted. This is especially problematic for rickettsial infections (Rocky Mountain spotted fever, ehrlichiosis, and anaplasmosis), because the risk of long-term morbidity and mortality increases with delayed treatment. We emphasize the need for clinicians to maintain a high index of suspicion for tick-borne infections; to diagnose these illnesses presumptively, without waiting for confirmatory laboratory test results; and to promptly start therapy with doxycycline, even in young children, when rickettsial infections are suspected.

16 Review Tick-borne diseases of the USA: Ten things clinicians should know. 2015

Buckingham, Steven C. ·Department of Pediatrics, University of Tennessee Health Science Center and Le Bonheur Children's Hospital, 50 N. Dunlap Street, Research Tower, Room 464R, Memphis, TN 38103 USA. Electronic address: sbucking@uthsc.edu. ·J Infect · Pubmed #25917805.

ABSTRACT: This article highlights critical aspects of the epidemiology, diagnosis, and management of tick-borne infections in children. Principles that apply broadly across the continental United States are emphasized, rather than details of each disease. Tick-borne infections are often confused with other, more common childhood illnesses, in part because of their nonspecific initial clinical findings and because patients are usually unaware of their preceding tick exposures. This is a problem, because delays in starting appropriate antibiotic therapy increase the likelihood of adverse outcomes from these infections, especially Rocky Mountain spotted fever (RMSF). For patients in whom RMSF is a reasonable diagnostic consideration, therapy should be started presumptively, without awaiting the results of confirmatory diagnostic tests. For both adults and children, doxycycline is the drug of choice for RMSF and other American rickettsial infections. Concerns over the potential toxicity of doxycycline in young children are unfounded. Similarly groundless is the belief in "chronic Lyme disease" as an explanation for persistent nonspecific complaints after completing antibiotic therapy for Lyme disease. Prevention of tick-borne infections rests on avoidance of tick-bites and prompt removal of attached ticks. When used appropriately, insect repellents containing DEET are safe and effective for preventing tick exposures.

17 Review Diseases from North America: focus on tick-borne infections. 2015

Nathavitharana, Ruvandhi R / Mitty, Jennifer A. ·Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA rnathavi@bidmc.harvard.edu. · Harvard Medical School, Boston, MA, USA. ·Clin Med (Lond) · Pubmed #25650204.

ABSTRACT: Tick-borne infections are seen throughout the United States, with varying geographical locations. Many of these infections are also increasingly seen in Europe. Certain ticks (eg Ixodes) can transmit more than one infection. Diagnosis, particularly in early infection, can be challenging and therefore knowledge of the distinguishing clinical features and epidemiology of these diseases is important. Testing for Lyme disease often causes confusion for patients and medical providers, as serological tests may be negative in early infection and conversely may be positive for years after infection. Newer tests, such as the C6 ELISA, may play a role in Lyme diagnosis. Additionally, the value of a simple blood film should not be underestimated for diagnosing babesiosis and anaplasmosis. In certain situations, empiric therapy may be required for tick-borne infections as severe illness with multiorgan failure can occur, particularly in older and immunocompromised hosts. This review describes the more commonly seen tick-borne infections: Lyme, babesiosis, anaplasmosis and Rocky Mountain Spotted Fever. More recently identified tick-borne infections, such as southern tick-associated rash illness and Borrelia miyamotoi, are also covered.

18 Review Atypical Rocky Mountain spotted fever with polyarticular arthritis. 2013

Chaudhry, Muhammad A / Scofield, Robert Hal. ·Department of Medicine (MAC, RHS), University of Oklahoma Health Sciences Center · Arthritis & Clinical Immunology Program (RHS), Oklahoma Medical Research Foundation · and Medical Service (RHS), Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma. ·Am J Med Sci · Pubmed #24157965.

ABSTRACT: BACKGROUND: Rocky Mountain spotted fever (RMSF) is an acute, serious tick borne illness caused by Rickettsia rickettsi. Frequently, RMSF is manifested by headache, a typical rash and fever but atypical disease is common, making diagnosis difficult. Inflammatory arthritis as a manifestation is rare. The purpose of this study is to describe a patient with serologically proven RMSF who presented in an atypical manner with inflammatory arthritis of the small joints of the hands and to review the previously reported patients with rickettsial infection and inflammatory arthritis. METHODS: An 18-year-old woman presented with a rash that began on the distal extremities and spread centrally, along with hand pain and swelling. She had tenderness and swelling of the metacarpophlangeal joints on examination in addition to an erythematosus macular rash and occasional fever. RESULTS: Acute and convalescent serology demonstrated R rickettsi infection. She was successfully treated with doxycycline. CONCLUSIONS: Inflammatory arthritis is a rare manifestation of RMSF or other rickettsial infection with 8 previously reported patients, only 1 of whom had RMSF. Physician must have a high index of suspicion for RMSF because of atypical presentations.

19 Review Update on tick-borne rickettsioses around the world: a geographic approach. 2013

Parola, Philippe / Paddock, Christopher D / Socolovschi, Cristina / Labruna, Marcelo B / Mediannikov, Oleg / Kernif, Tahar / Abdad, Mohammad Yazid / Stenos, John / Bitam, Idir / Fournier, Pierre-Edouard / Raoult, Didier. ·Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, Marseille, France. ·Clin Microbiol Rev · Pubmed #24092850.

ABSTRACT: Tick-borne rickettsioses are caused by obligate intracellular bacteria belonging to the spotted fever group of the genus Rickettsia. These zoonoses are among the oldest known vector-borne diseases. However, in the past 25 years, the scope and importance of the recognized tick-associated rickettsial pathogens have increased dramatically, making this complex of diseases an ideal paradigm for the understanding of emerging and reemerging infections. Several species of tick-borne rickettsiae that were considered nonpathogenic for decades are now associated with human infections, and novel Rickettsia species of undetermined pathogenicity continue to be detected in or isolated from ticks around the world. This remarkable expansion of information has been driven largely by the use of molecular techniques that have facilitated the identification of novel and previously recognized rickettsiae in ticks. New approaches, such as swabbing of eschars to obtain material to be tested by PCR, have emerged in recent years and have played a role in describing emerging tick-borne rickettsioses. Here, we present the current knowledge on tick-borne rickettsiae and rickettsioses using a geographic approach toward the epidemiology of these diseases.

20 Review Ecology, biology and distribution of spotted-fever tick vectors in Brazil. 2013

Szabó, Matias P J / Pinter, Adriano / Labruna, Marcelo B. ·Laboratório de Ixodologia, Faculdade de Medicina Veterinária, Universidade Federal de Uberlândia Uberlândia, Brazil. szabo@famev.ufu.br ·Front Cell Infect Microbiol · Pubmed #23875178.

ABSTRACT: Spotted-fever-caused Rickettsia rickettsii infection is in Brazil the major tick-borne zoonotic disease. Recently, a second and milder human rickettsiosis caused by an agent genetically related to R. parkeri was discovered in the country (Atlantic rainforest strain). Both diseases clearly have an ecological background linked to a few tick species and their environment. Capybaras (Hydrochoerus hydrochaeris) and Amblyomma cajennense ticks in urban and rural areas close to water sources are the main and long-known epidemiological feature behind R. rickettsii-caused spotted-fever. Unfortunately, this ecological background seems to be increasing in the country and disease spreading may be foreseen. Metropolitan area of São Paulo, the most populous of the country, is embedded in Atlantic rainforest that harbors another important R. rickettsii vector, the tick Amblyomma aureolatum. Thus, at the city-forest interface, dogs carry infected ticks to human dwellings and human infection occurs. A role for R. rickettsii vectoring to humans of a third tick species, Rhipicephalus sanguineus in Brazil, has not been proven; however, there is circumstantial evidence for that. A R. parkeri-like strain was found in A. ovale ticks from Atlantic rainforest and was shown to be responsible for a milder febrile human disease. Rickettsia-infected A. ovale ticks are known to be spread over large areas along the Atlantic coast of the country, and diagnosis of human infection is increasing with awareness and proper diagnostic tools. In this review, ecological features of the tick species mentioned, and that are important for Rickettsia transmission to humans, are updated and discussed. Specific knowledge gaps in the epidemiology of such diseases are highlighted to guide forthcoming research.

21 Review Rocky Mountain spotted fever in children. 2013

Woods, Charles R. ·Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY 40202, USA. charles.woods@louisville.edu ·Pediatr Clin North Am · Pubmed #23481111.

ABSTRACT: Rocky Mountain spotted fever is typically undifferentiated from many other infections in the first few days of illness. Treatment should not be delayed pending confirmation of infection when Rocky Mountain spotted fever is suspected. Doxycycline is the drug of choice even for infants and children less than 8 years old.

22 Review Imaging of rickettsial, spirochetal, and parasitic infections. 2012

Akgoz, Ayca / Mukundan, Srini / Lee, Thomas C. ·Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. ·Neuroimaging Clin N Am · Pubmed #23122260.

ABSTRACT: This article is an update and literature review of the clinical and neuroimaging findings of the commonly known rickettsial, spirochetal, and eukaryotic parasitic infections. Being familiar with clinical presentation and imaging findings of these infections is crucial for early diagnosis and treatment especially in patients who live in or have a travel history to endemic regions or are immunocompromised.

23 Review Rocky Mountain spotted fever: 'starry sky' appearance with diffusion-weighted imaging in a child. 2012

Crapp, Seth / Harrar, Dana / Strother, Megan / Wushensky, Curtis / Pruthi, Sumit. ·Department of Radiology, Division of Pediatric Neuroradiology, Monroe Carell Jr. Children's Hospital at Vanderbilt University, 2200 Children's Way, Nashville, TN 37232, USA. ·Pediatr Radiol · Pubmed #21881936.

ABSTRACT: We present a case of Rocky Mountain spotted fever encephalitis in a child imaged utilizing diffusion-weighted MRI. Although the imaging and clinical manifestations of this entity have been previously described, a review of the literature did not reveal any such cases reported in children utilizing diffusion-weighted imaging. The imaging findings and clinical history are presented as well as a brief review of this disease.

24 Review Tick-borne illnesses: a CME update. 2011

Graham, Jennifer / Stockley, Katrina / Goldman, Ran D. ·Division of Pediatric Emergency Medicine, BC Children's Hospital, Department of Pediatrics, University of British Columbia, Child & Family Research Institute (CFRI), Vancouver, British Columbia, Canada. ·Pediatr Emerg Care · Pubmed #21293226.

ABSTRACT: North American tick-borne illnesses are a group of important emerging diseases whose incidence has been increasing for the past decade. Emergency physicians may be the first contact for patients with symptoms of tick-borne illness, thus it is important that these diseases remain on a physicians' differential diagnosis when presented with an appropriate clinical presentation. This CME activity provides an overview of the most common tick-borne illnesses in North America and will help physicians evaluate their clinical presentation, order appropriate diagnostic tests, develop pediatric treatment recommendations, and prepare to include tick-borne illnesses in the differential diagnosis of pediatric patients presenting with multisystem disease.

25 Review Looking the other way: preventing vector-borne disease among travelers to the United States. 2010

Hayes, Edward B. ·Barcelona Centre for International Health Research, Rosello 132, 08036 Barcelona, Spain. ned.hayes@cresib.cat ·Travel Med Infect Dis · Pubmed #20971437.

ABSTRACT: Millions of travelers visit the United States every year during warm months when risk of vector-borne disease is highest. The epidemiology and geographic distribution of the principal vector-borne diseases in the United States are reviewed and recommendations for visitors to reduce their risk of disease are described. Travel advice should focus on preventing Lyme disease, anaplasmosis and babesiosis in the northeast and north central States, West Nile virus disease in western plains States, and Rocky Mountain spotted fever and tularemia in the southeast; other diseases and itineraries requiring particular attention are described. All travelers to the United States should be advised to practice personal protection against arthropod bites, including appropriate use of insect repellents, especially when visiting rural and suburban areas during the warm months.