Show:
Could be bad
Might kill ya
Kinda itchy
Who bit me
I feel funny
100
  • Neurotoxin from salivary gland
  • Rising paralysis 
  • Dx: finding a tick
  • Tx: remove tick —> recovery in 24 hrs.

Tick paralysis

100
  • Arbovirus by dear tick
  • Non specific prodrome —> viral encephalitis 

Powassan disease: 

100
  • >60% in NC, Tennessee, Oklahoma, Missouri, and Arkansas
  • Brown dog tick -->Deer, rodents, horses, cattle, cats, and dogs
  • Rash: day 2-4, starts hands, feet , wrists and angles —> centripetally to trunk
  • Conjunctival injection, bilateral periorbital edema
  • Normal white and red cell counts, thrombocytopenia, mild elevation of liver enzymes, hyponatremia
  • Tx: Doxy

Rocky Mountain spotted fever

100
  • Blunt tweezers, grab close to skin, disinfect skin
  • Save tick in alcohol for further ID

How to remove a tick

100

 Ingestion of uncooked or raw meat, ingestion of the oocysts from cat and wild-animal feces; and transplacentally

fetal abnormalities including retinochoroiditis, hydrocephalus, hepatosplenomegaly, and thrombocytopenia

Tx: pyrimethamine (25 to 100 milligrams/d PO for 3 to 4 weeks) plus sulfadiazine (1.0 to 1.5 grams PO four times a day for 3 to 4 weeks) and folinic acid.

Toxoplasma gondii

200
  • Animal hide, raw wool
  • Inflation 100% fatal 
  • 60-day antibiotic course combined with a three-dose vaccination course used in postexposure prophylaxis
  • Tx: doxycycline or ciprofloxacin + Pen G, Vanc, rifampin

Anthrax

200

Stage one of lyme disease presentation 

Erythema migrans - 60-80% - 2-30 days, vasculitis

  • Fever chills, fatigue, mayalgias, arthralgias, and lymphadenopathy
  • Untreated - resolves in 3-4 w.
200
  • Fluelike illness
  • Mosquitoes
  • Tx: Supportive care 

West Nile

200

Infection originating from non human vertebrates or transmitted from insects to humans 

Zoonoses

200
  • From unpasteurized dairy, inhalation
  • Sy: cough, productive sputum, hoarseness of voice dyspnea, wheezing
  • Tx: Doxycycline + rifampin 6 weeks

Brucellosis

300
  • Parrot fever - pigeons, sparrows, ducks, hens
  • Dust from dried bird feces, avian respiratory secretions, direct contact
  • Incubation: 5-14 days. fever, chills, cephalgia, myalgia, and generalized malaise
  • Non productive cough
  • Dx: Doxycycline

Psittacosis

300

2nd stage of Lyme disease presentation

  • Disseminated - days to months after bite ever, adenopathy, neuropathies, heart block, arthritic complaints, and skin lesions
  • Cranial neuritis, most often unilateral or bilateral facial nerve palsy
  • Bonus: periodic headache, neck stiffness, difficulty in mentation, cerebellar ataxia, myelitis, encephalitis, motor or sensory radiculoneuritis, mononeuritis multiplex, and facial palsy
300
  • is a rickettsial infection - aerosol inhalation
  • Cattle, sheep, goats  - urine, afterbirth, feces
  • Self limiting, pulmonary manifestations, carditis
  • Nonspecific infiltrates on chest radiograph
  • Tx: Doxycycline

Q fever - (Coxiella burnetii) 

300
  • If clearly ID Ixodes scapulars  attached >36 hrs, or obvious engorgement
  • Area w/ Borrelia burgdorfere carrier rate >20%
    • Doxycycline 200 mg adults
      • 4 mg / kg kids

Prophylactic treatment of Lyme disease

300

Identical to Lyme disease but no cardiac or CNS 

Target rash

Vector: lone star tick

Self limiting 

SOUTHERN TICK-ASSOCIATED RASH ILLNESS (STAR)

400
  • Vector: exodus tick
  • Reservoirs - rodents, domesticated animals, deer
  • Sy: malaise, anorexia, fever, and chills; sweats, myalgia, headache, and hemolytic anemia
  • Dx: hemolysis, liver dysfunction, anemia, thrombocytopenia, and renal failure
  • Intraerythrocytic rings 
  • Tx:  7 to 10 days with atovaquone plus azithromycin or clindamycin, with quinine added for severely ill patients

BABESIOSIS

400

Months to years after bite - chronic arthritis, myocarditis, subacute encephalopathy, axonal polyneuropathy, and leukoencephalopathy

Stage 3 of Lyme disease

400
  • RNA virus, Coltivirus, family Reoviridae
  • Vector: wood tick
  • Reservoir: deer, marmots and porcupines
  • Western mountainous regions
  • incubation period is 3 to 5 days
  • illness has fever, chills, headache, myalgia, and photophobia
  • Self limiting

Colorado tick fever

400
  • Dog and cat oral flora
  • Cause necrotizing cellulitis; Rarely bronchitis
  • Tx: Amoxicillin-clavulanate, Doxy, Pen or 3rd get Cephalosporin

Pasteurellosis

400

Category of zoonotic diseases

  • Dogs and domesticated farm animals can be the source of Streptococcus species, Corynebacterium ulcerans, Yersinia species, and viral vesicular stomatitis

Upper respiratory zoonotic infections

500
  • Relapsing fever, gram-negative Borrelia spirochetes
  • Texas
  • Vectors: Ornithodoros ticks
  • Reservoirs - tree squirrels and chipmunks
  • Rash, 2- to 3-mm pruritic eschar at the site of a tick bite
  • fever, headache, chills, cephalgia, myalgia, arthralgia, abdominal pain, and general malaise
  • 3-day-long febrile episodes are interspersed with 7-day-long afebrile periods
  • Dx: clinical or spirochetes on darkfield microscopy or Wright-Giemsa–stained peripheral blood smears
  • Tx: tetracycline or erythromycin; IV ceftriaxone 10-14 days for CNS

Tick-Borne relapsing fever

500
  • Vector- lone star tick-> Reservoirs - white tail deer
  • Sy: 1-2 s/p bite prodromal
  • Acute phase <4 weeks, leukocytopenia, thrombocytopenia, and elevation of hepatic enzymes
  • Dx: clinical; Blood smear - e..... in WBCs 20%, imunoflurescence assay
  • Tx: Doxycycline 3-5 days after fever resolves or 10-14 days after CNS sy; Rifampin as alternative to doxy

EHRLICHIOSIS

500
  • Most case in Sub-Saharan Africa, rock squirrels, rodents
  • Vector: rotent flea
  • Incubation 2-10 days
  • Eschar at bite site, bubo, sepsis, pneumonia
  • Tx: parenteral streptomycin or gentamicin —> PO Doxy, Cipro, or chloramphenicol

Pulmonic Plague

500
  • Gram (-) coccobacillus
  • North America, north Asia, Europe
  • Vector: Dog and wood, and Lone star tick, and flies or inhaled 
  • Reservoirs: rabbits, deer
  • Incubation 3-6 days
  • Prez: Ulceroglandular - maculopappular lesion that ulcerates with painful regional adenopathy and systemic symptoms.
  • Tx: streptomycin; gentamicin, ciprofloxacin, imipenem, doxycycline, and chloramphenicol

Tularemia

500
  • Arboviral infection - arthropod or insect vector 
  • Non viral: Bartonella henselae, Brucella canis, borreliosis, Coxiella burnetii, Ehrlichia species, listeriosis, leptospirosis, Lyme disease, Rocky Mountain spotted fever, psittacosis, and toxoplasmosis
  • Prez: malaise, myalgia, and fever —> h/a & decline in mental status 
  • Dx: CSF: inc opening pressure, elevated protein, normal glucose, high lymphocytes
  • Tx: supportive

Zoonotic Encephalitis and Meningitis