Tick-Borne Diseases =================== þ Rocky Mountain Spotted Fever þ Lyme Disease þ Ehrlichia - nonmotile gram negative intracellular bacteria - probably tick-transmitted: of 257 reported cases, 3/4 had a tick bite - varies from mild to life threatening: fever and headache in 100%, nausea, vomiting, and abdominal pain in 72%, nonspecific myalgia and rash in 60%. - may have leukopenia, lymphopenia and thrombocytopenia - blood cultures rarely positive - CDC offers immunofluorescent antibody test - drugs of choice: tetracycline and possibly chloramphenical cause improvement in about a week. - three fatalities reported þ Babesiosis - malaria-like - caused by intraerythrocytic parasite Babesia microti - transmitted by bite of deer tick - cases from New England to California - unlike Lyme disease, incidence is higher in adults than children, but may be underdiagnosed in children as milder - symptoms and signs: fever, chills, fatigue, splenomegaly, anemia - may observe on Giemsa-stained blood - may diagnose by four-fold increase in antibody titre - drugs of choice: chloroquine and quinine along with clindamycin [Wingert W. Tick bite related diseases other than Lyme. Wild Med Ltr 1993;10(1):11.]