Thread by @ilads_lyme

Amy Offutt, MD: Rickettsial & Related Diseases
• #RMSF Rocky Mountain Spotted Fever
• #Ehrlichiosis
• #Anaplasmosis
• #Qfever
• #Scrubtyphus
#ILADS2022

2/Offutt Ticks are the primary vectors for spotted fevers; some species may be spread by fleas and mites #ILADS2022 #RMSF #Richettsia

3/Offutt: #RMSF is the most severe rickettsial illness in the US with risk of death. Early treatment with #doxycycline is critical, regardless of age #ILADS2022

4/Offutt: #Ehrlichia chaffeensis and ewingii transmitted by the lone star tick primarily in SE; Ehrlichia muris-like agent - referred to as EML, identified in 2011 in midwestern states, transmitted by the blacklegged tick #ILADS2022

5/Offutt: #Ehrlichia symptoms include acute febrile illness w/highly variable symptoms (headache, malaise, myalgia, &/or GI symptoms onset 5-14 days after tick bite (but many won't remember the bite). Should be considered in differential diagnosis esp. in spring/summer #ILADS2022

6/Offutt: #Anaplasmosis: Principal vector in northeastern & midwestern U.S. is Ixodes scapularis, & is Ixodes pacifus in the western U.S. #ILADS2022

7/Offutt: #Anaplasmosis symptoms include #fever #headache #myalgia #nausea #vomiting #confusion and rarely is fatal

8/Offutt: It is important not to wait for rash to treat suspected #RMSF. Clinical diagnosis if #fever plus 1: #rash #Eschar #headache #myalgia #anemia #Thrombocytopenia, elevated serum hepatic transaminases #ILADS2022

9/Offutt: Acute laboratory findings for #rickettsial infections may include: Leukopenia, thrombocytopenia, mild hyponatremia, and mildly elevated hepatic transaminase levels are common and particularly useful; absence of these does not exclude a diagnosis. #ILADS2022

10/Offutt: Treat if clinical presentation of #RMSF or other rickettsial infection - do not wait for confirmatory labs. #Doxycycline is recommended antibiotic even in children (studies have shown minimal to no risk of tooth staining) #ILADS2022