Jantausch B A
Department of Infectious Diseases, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC.
Ann Allergy. 1994 Jul;73(1):4-11; quiz 11-2.
The goal of this review is to facilitate the management of patients with tick-associated diseases. This article will discuss the epidemiology, clinical diagnosis, and antimicrobial therapy of Lyme disease, Rocky Mountain spotted fever, and ehrlichiosis.
References are limited to the English language and extend back to the beginning of the twentieth century. The human and veterinary literature were reviewed. Sources include computerized databases and bibliographies of recent articles and books.
Papers were selected on the basis of their timeliness, explanation of important findings by major investigators, extrapolation of clinical data from large patient populations, and clarification of controversial issues. Approximately 50% of the articles initially reviewed are included in the bibliography.
Standardization of laboratory testing for Lyme disease should facilitate more accurate diagnosis in the future. Clinical diagnosis of Rocky Mountain spotted fever and ehrlichiosis prior to laboratory confirmation is necessary in order to ensure timely institution of antimicrobial therapy.
Knowledge of endemic regions and seasonal cycles of vectors, varying clinical presentations of disease and appropriate utilization of the laboratory are critical for the appropriate diagnosis and management of patients with tick-associated diseases.
本综述的目的是促进蜱传播疾病患者的管理。本文将讨论莱姆病、落基山斑疹热和埃立克体病的流行病学、临床诊断及抗菌治疗。
参考文献限于英文，可追溯至20世纪初。对人类和兽医文献进行了综述。资料来源包括计算机数据库以及近期文章和书籍的参考文献目录。
根据论文的时效性、主要研究者对重要发现的解释、从大量患者群体中推断临床数据以及对有争议问题的阐明来选择论文。最初审阅的文章中约50%被列入参考文献目录。
莱姆病实验室检测的标准化应有助于未来更准确的诊断。为确保及时进行抗菌治疗，在实验室确诊前对落基山斑疹热和埃立克体病进行临床诊断很有必要。
了解流行地区、病媒的季节性周期、疾病的不同临床表现以及实验室的合理利用对于蜱传播疾病患者的正确诊断和管理至关重要。
