Last reviewed:December 2019
Last updated:August  2018

Summary

Definition

History and exam

Key diagnostic factors

  • spring or summer season
  • fever
  • localized unilateral lymphadenopathy
  • painful skin ulcer
  • unilateral conjunctivitis

Other diagnostic factors

  • rales
  • nonproductive cough/dyspnea
  • systemic toxicity symptoms
  • sore throat
  • photophobia
  • jaundice, hepatosplenomegaly, diarrhea
  • positive Kernig/Brudzinski sign, stiff neck

Risk factors

  • tick exposure
  • biting fly exposure
  • contact with infected animals
  • yard work in areas where infected animals live

Diagnostic investigations

Treatment algorithm

Contributors

William A. Petri, Jr.

Wade Hampton Frost Professor of Epidemiology

Professor of Medicine, Microbiology, and Pathology

Chief, Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Peer reviewersVIEW ALL

Assistant Professor of Medicine

Division of Infectious Diseases

University of Vermont College of Medicine

Burlington

VT

Disclosures

CH declares that he has no competing interests.

Assistant Professor

Infectious Diseases

University of Vermont College of Medicine

Burlington

VT

Disclosures

BK declares that she has no competing interests.

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