Department of Dermatology, Geisinger Medical Center, 100 North Academy Ave, Danville, Pennsylvania, USA.
Curr Opin Infect Dis. 2010 Apr;23(2):132-8. doi: 10.1097/QCO.0b013e328335b09b.
Fever and a rash following a tick bite can signify a true medical emergency. Ticks are important vectors of disease worldwide, including Rocky Mountain spotted fever, Lyme disease, and Congo-Crimean hemorrhagic fever. This paper will review the major ticks of medical importance and the diseases they transmit, including important emerging pathogens.
Rocky Mountain spotted fever continues to be the most lethal tick-borne illness in the United States and is emerging as an important disease in South America. Other important emerging diseases include human anaplasmosis, southern tick associated rash illness, human monocytic ehrlichiosis, and a variety of rickettsial fevers including those caused by Rickettsia parkeri and Rickettsia amblyommii.
Most tick-borne illnesses respond readily to doxycycline therapy. In the case of Rocky Mountain spotted fever, therapy should be started when the disease is suspected and should never be delayed for confirmatory tests. Accurate identification of tick vectors can help establish a diagnosis and can help guide preventive measures to reduce the burden of disease.
被蜱虫叮咬后出现发热和皮疹可能表示出现了真正的医疗紧急情况。蜱虫是全球范围内重要的疾病传播媒介，包括落矶山斑点热、莱姆病和刚果-克里米亚出血热。本文将回顾具有重要医学意义的主要蜱虫种类以及它们传播的疾病，包括重要的新兴病原体。
落矶山斑点热仍是美国最致命的蜱传疾病，并在南美洲成为一种重要疾病。其他重要的新兴疾病包括人类无形体病、南方蜱相关皮疹病、人单核细胞埃立克体病，以及各种立克次体热，包括由帕克立克次体和 amblyommii 立克次体引起的热。
大多数蜱传疾病对多西环素治疗反应良好。在落矶山斑点热的情况下，应在怀疑该病时即开始治疗，决不应因确诊试验而延迟。准确识别蜱虫媒介有助于确立诊断，并有助于指导预防措施以减轻疾病负担。
