Diagnosis and treatment of tick infestation and tick-borne diseases with cutaneous manifestations

Abstract

Hard and soft ticks may be associated directly or indirectly with a number of dermatoses, both infectious and inflammatory in origin. Morbidity may occur as a result of tick bites, tick toxicosis, and even infestation. These arthropod vectors may transmit life-threatening protozoan, bacterial, rickettsial, and viral diseases with systemic and cutaneous findings. Additionally, ticks may transmit more than one pathogen with subsequent human coinfection. This article reviews the presentation of tick-borne illnesses and the medical management of these diseases. Among others, diseases such as ehrlichiosis, anaplasmosis, babesiosis, tularemia, borrelioses, tick-borne encephalitides, rickettsial spotted fevers, and tick typhus are discussed in this article. The recognition of skin manifestations associated with these diseases is paramount to early diagnosis and treatment initiation.

Update on tick-borne bacterial diseases in Europe

“…In this review, we describe the bacterial tick-borne diseases in European countries, focusing on the epidemiological and clinical aspects of tick-borne rickettsioses, with overviews of other tick-borne diseases. For diagnostic strategies, we refer to recent reviews Dana, 2009). …”

Lyme disease

“…26,27 Moreover, in the eastern and south central United States, another tickborne zoonosis caused by Borrelia lonestari has been described. [28][29][30][31] It is transmitted by the Lone Star tick (Amblyomma americanum).…”

Variation in Tularemia Clinical Manifestations—Arkansas, 2009–2013

“…The incubation period for tularemia infection is typically 3–5 days, but it can be up to 21 days [2–5, 9]. …”

“…Classic tularemia is characterized by regional lymphadenopathy with or without skin or mucosal ulceration (ulceroglandular or glandular forms, respectively) [9]. This form has historically been confused with the “plague” in geographic areas of the world where Yersinia pestis is endemic [5].…”

“…Historically, this manifestation was a diagnosis of exclusion and less commonly reported than classic forms [10, 11]. Lymphohematogenous dissemination of the organism can lead to more severe disease forms, including meningitis, with the highest mortality [4, 9, 12]. The organism is highly infectious…”