Tick Bite
Epidemiology
Clinical Manifestations
Allergic Reactions
Anaphylaxis (see Anaphylaxis )
Epidemiology
Associated Ticks
Argas Reflexus (European Pigeon Tick)
Ixodes Holocyclus Tick (Australian Paralysis Tick)
Other Ixodes Ticks
Physiology : likely involves allergenic salivary proteins
Allergic Reaction/Anaphylaxis Due to Tick Bite-Induced Sensitization to Alpha-Galactosidase (see Anaphylaxis )
Physiology : tick bite sensitizes the patient to the carbohydrate, alpha-galactosidase
Alpha-Galactosidase is Found in Cetuximab (Erbitux) (see Cetuximab )
Alpha-Galactosidase is Found in Red Meats
Clinical
Alpha-Galactosidase Associated Cetuximab (Erbitux) Allergy (see Cetuximab ): may occur on first exposure and may be severe, resulting in anaphylaxis
Alpha-Galactosidase Associated Read Meat Allergy: unusual in that it has a delayed onset (occurring 4-6 hrs after meat ingestion)
Infectious Transmission
Anaplasmosis (Human Granulocytic Anaplasmosis, HGA) (see Anaplasmosis )
Organisms
Anaplasma Phagocytophilum
Animal Reservoir : deer, white-footed mouse
Vectors
Ixodes Scapularis Tick (Blacklegged Tick): Connecticut, Maryland, Minnesota, New York, Rhode Island, and Wisconsin
Ixodes Pacificus Tick (Western Blacklegged Tick): Western US
Ixodes Ricinus Tick: Europe
Babesiosis (see Babesiosis )
Organisms
Babesia Microti
Geography: Northeastern and Upper Midwest US
Animal Reservoir: white-tailed deer and mice
Tick Vector: Ixodes Scapularis (Blacklegged Tick)
Incubation Period: 5-33 days
Babesia Divergens
Geography: Europe
Animal Reservoir: cattle
Tick Vector: Ixodes Ricinus
Other Babesia Species
Bourbon Virus Infection (see Bourbon Virus )
Vector
Amblyomma Americanum Tick (Lone Star Tick): eastern Kansas, Missouri
Ehrlichiosis (Human Monocytic Ehrlichiosis, HME) (see Ehrlichiosis )
Organisms
Ehrlichia Chafeensis : most common etiology of Ehrlichiosis
Ehrlichia Ewingii less common etiology of Ehrlichiosis
Ehrlichia Muris -Like Species
Vector
Amblyomma Americanum Tick (Lone Star Tick)
Lyme Disease (see Lyme Disease )
Epidemiology : Lyme disease is the most common tick-borne illness in the US and Europe
Organisms
Borrelia Burgdorferi : US, Europe
Borrelia Mayonii : Upper Midwest US
Borrelia Afzelii : Europe, Asia
Borrelia Garinii : Europe, Asia
Vectors
Ixodes Scapularis (Blacklegged Tick): in Eastern and North Central North America
Primary Animal Reservoir (in Northeastern US): white-footed mouse
Ixodes Pacificus (Western Blacklegged Tick): in Western North America (Northern California and Oregon)
Ixodes Persculatus : in Asia
Ixodes Ricinus : in Europe
Relapsing Fever (Tick-Borne) (see Relapsing Fever )
Organisms
Borrelia Hermsii : in Mountainous Western US
Borrelia Turicatae : in Southwest and South Central US
Other Borrelia Species
Vectors
Argasid/Soft-Bodied Ticks : usually Ornithodoros
Rocky Mountain Spotted Fever (see Rocky Mountain Spotted Fever )
Organism : Rickettsia Ricketsii (see Rickettsia )
Vectors
Amblyomma Aureolatum Tick (Yellow Dog Tick): Brazil
Amblyomma Cajennense Tick: Central and South America
Dermacentor Andersoni Tick (Rocky Mountain Wood Tick): US Mountain States West of the Mississippi
Dermacentor Variabilis Tick (American Dog Tick): Eastern US, South Central US, Southern Canada
Rhipicephalus Sanguineus Tick (Brown Dog Tick): Central America, Mexico, Southwestern US
Tick-Borne Encephalitis Virus (see Tick-Borne Encephalitis Virus )
Tularemia (see Tularemia )
Epidemiology : most common in Central and Western US
Organisms
Francisella Hispaniensis
Francisella Philomiragia
Francisella Tularensis
Other Francisella Species
Vector
Diagnosis
Clinical
Rash and tick bite history are often absent
Treatment
Lyme Disease: Tetracycline, Ceftriaxone
Babesiosis: Clinda + Quinine (for life-threatening illness), Atovaquone+Azithro (for non-life threatening illness
Ehrlichiosis: Tetracycline
Tularemia: Gentamicin
Rocky Mountain Spotted Fever: Tetracycline, Chloramphenicol
References
Tick-Borne Pulmonary Disease; Chest, 1999: 116: 222-230
The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose. J Allergy Clin Immunol. 2011;127(5):1286. Epub 2011 Mar 31 [MEDLINE ]
Human babesiosis. N Engl J Med. 2012;366:2397–2407 [MEDLINE ]
The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 2015;135(3):58 [MEDLINE ]
Diagnosis, treatment and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis. JAMA. 2016;315:1767–1777 [MEDLINE ]
CDC Tickborne Diseases of the United States (Accessed 7/17) [LINK ]
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