Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- known recent tick exposure or bite
- triad of fever, rash, and history of tick exposure
- triad of fever, rash, and headache
- fever
- rash
- headache
- nausea/vomiting
- myalgia
- altered mental status
Другие диагностические факторы
- abdominal pain
- residence in or recent exposure to rural area
- diarrhea
- conjunctivitis
- lymphadenopathy
- peripheral edema
- meningismus
- splenomegaly
- hepatomegaly
- jaundice
- seizures
- shock
- coma
Факторы риска
- illness onset in spring or summer
- returned travelers from an endemic area
- recent (within 2 weeks) outdoor exposure
- known antecedent tick bite
- exposure to dogs or pets that spend time outdoors
Диагностические исследования
Исследования, которые показаны в первую очередь
- CBC
- serum electrolytes and blood urea nitrogen
- LFTs
- indirect immunofluorescent antibody
- blood culture
Исследования, проведение которых нужно рассмотреть
- complement fixation
- latex agglutination
- indirect hemagglutination
- microagglutination
- enzyme immunoassay
- lumbar puncture
- convalescent serology
- chest x-ray
- abdominal CT scan
- immunohistochemistry
- polymerase chain reaction
Алгоритм лечения
suspected Rocky Mountain spotted fever
Составители
Авторы
Christopher A. Ohl, MD
Professor of Medicine
Section on Infectious Diseases
Wake Forest School of Medicine
Winston-Salem
NC
Раскрытие информации
CAO declares that he has no competing interests.
Выражение благодарностей
Professor Christopher A. Ohl would like to gratefully acknowledge Dr Steven C. Buckingham, a previous contributor to this topic. SCB is an author of several references cited in this topic. We were made aware that Dr Steven C. Buckingham is now deceased.
Рецензенты
Mary Anne Jackson, MD
Chief
Section of Pediatric Infectious Diseases
Children's Mercy Hospital and Clinics
Professor of Pediatrics
University of Missouri-Kansas City School of Medicine
Kansas City
MO
Раскрытие информации
MAJ is an author of several references cited in this topic.
Список литературы
Основные статьи
Biggs HM, Behravesh CB, Bradley KK, et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsioses, ehrlichioses, and anaplasmosis - United States. MMWR Recomm Rep. 2016;65:1-44.Полный текст Аннотация
Centers for Disease Control and Prevention. Tickborne diseases of the United States: a reference manual for health care providers, sixth edition. Aug 2022.Полный текст
Centers for Disease Control and Prevention. Rocky Mountain spotted fever: information for healthcare providers. Feb 2019 [internet publication].Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Other rickettsial diseases
- Meningococcemia
- Ehrlichiosis
Больше ОтличияРекомендации
- CDC Health information for international travel (the Yellow Book): rickettsial diseases
- Tickborne diseases of the United States: a reference manual for health care providers
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