Respiratory Manifestations of Tick-Borne Diseases in the Southeastern United States

Rp, Byrd; Vásquez, J; Tm, Roy

doi:10.1097/00007611-199701000-00001

Cited by 19 publications

(7 citation statements)

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“…However, the principal port of entry is through the skin 2,3,5 . F. tularensis has been isolated in wells that contained dead rodents and carcasses 4,5…”

Section: Discussionmentioning

confidence: 99%

An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side

et al. 2009

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PurposeWe describe the epidemiological and clinical characteristics and the efficacy of a delayed initiation to therapy in an oropharyngeal tularemia outbreak in Duzce, Turkey.Materials and MethodsBetween March and June 2000, 22 patients with tularemia were diagnosed by microagglutination tests.ResultsOropharyngeal and ulceroglandular forms of the disease were discovered. Most of the cases were oropharyngeal (19 cases). The most common symptoms were sore throat (95.4%) and fever (90.9%). Lymphadenopathy (95.4%) and pharyngeal hyperemia (81.8%) were usually observed signs. The lymphadenopathies were localized especially in the left cervical region (66.7%), a finding that has not been previously reported in the literature. The time between the onset of the symptoms and diagnosis was 40.7 ± 22.8 (10 - 90) days. The patients were treated with streptomycin plus doxycycline and ciprofloxacin. The patients' recoveries took up to 120 days.ConclusionThis report describes the first outbreak of tularemia in northwest Turkey. Tularemia may occur in any region where appropriate epidemiological conditions are found and should be kept in mind for differential diagnosis in oropharyngeal symptoms. Late initiation of therapy may delay complete recovery. In this outbreak, cervical lymph nodes predominantly localized on the 1eft side were found, which had not been previously reported.

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“…However, the principal port of entry is through the skin 2,3,5 . F. tularensis has been isolated in wells that contained dead rodents and carcasses 4,5…”

Section: Discussionmentioning

confidence: 99%

An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side

et al. 2009

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“…Pulmonary infiltrates develop in 75 percent of children and in 39 percent of adults with the disease, and the acute respiratory distress syndrome has occurred in between 11 percent and 18 percent of cases reported in the literature. 38 In the lung, there may be an interstitial lymphocytic pneumonitis with an organizing pneumonia rich in macrophages (in cases of subacute lung disease) or diffuse alveolar damage (in cases of acute lung disease) ( Fig. 5 and 6).…”

Section: Pathological Discussionmentioning

confidence: 99%

Case 37-2001

Yawetz¹,

Mark²

2001

N Engl J Med

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A 76-year-old man was admitted to the hospital because of atrial fibrillation and increasing dyspnea.The patient had been well until three weeks earlier, during an unseasonably warm period in late autumn, when a nonproductive cough without fever developed. Nine days later, the cough became productive, although the patient remained afebrile. Azithromycin was prescribed, but fever and chilliness developed, with nausea, vomiting, anorexia, mild bitemporal headache, and abdominal pain. He stopped taking the azithromycin after four days.Three days before admission, the patient went to a local hospital, where the temperature was 37.9°C and conjunctival injection was noted. The white-cell count was 5000 per cubic millimeter, and a radiograph of the chest reportedly showed no abnormalities. Normal saline was infused, and the patient was sent home. Two days later, the temperature rose to 38.9°C; he had a mild headache and was unable to arise from bed without assistance. He was taken to the same hospital, where he reported anorexia and abdominal fullness, without vomiting, chest pain, dyspnea, cough, abdominal pain, or joint pain. The temperature was 37.7°C. No rash was seen, and the lungs were clear. A grade 2 systolic murmur was heard. The urine was positive (+) for protein but was otherwise normal. Laboratory tests were performed (Tables 1 and 2). An electrocardiogram revealed atrial fibrillation at a ventricular rate of 130 beats per minute, without evidence of ischemic changes. A chest radiograph showed normal findings except for the presence of tiny pleural effusions. Abdominal radiographs revealed no abnormalities.Specimens were obtained for culture, and fluids were given. Wheezing developed and was accompanied by increasing dyspnea but no chest pain. The arterial oxygen saturation was 88 percent while the patient was breathing ambient air, and crackles were heard over the lower half of both lung fields. A repeated chest radiograph revealed increased interstitial markings with air-space opacities in the middle and lower regions of both lungs. Furosemide, nebulized albuterol, nitroglycerin paste, and morphine were administered, and he was transferred to this hospital. The patient resided on the island of Nantucket, Massachusetts, and had retired from a sedentary occupation. A heart murmur had been detected during childhood, and he and his identical twin brother had had bouts of paroxysmal atrial fibrillation. He had smoked two packs of cigarettes daily beginning at the age of 16 years but had stopped smoking at the age of 36. Prostatic carcinoma had been found on biopsy three years before admission. He drank moderate amounts of alcohol and was a sexually active homosexual man. There was no history of hypertension, diabetes mellitus, chest pain, rash, arthralgia, or congestive heart failure. A brother in his 60s had an implanted defibrillator.The temperature was 38.3°C, the pulse was 120 and irregular, and the respirations were 22. The blood pressure was 150/80 mm Hg. The oxygen saturation *To convert the values for i...

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“…Rocky Mountain spotted fever is a tickborne illness caused by Rickettsia rickettsii and is the most common rickettsial disease in the United States. 2 It occurs primarily during the warmer months, but confirmed cases have been reported throughout the year. 3 Involvement of the palms and soles, which is often considered diagnostically important, usually occurs relatively late in the disease course (after day 5 in 43% of cases) and does not occur at all in 18% to 64% of cases.…”

Section: Based On the History And Physical Examination Findings Whicmentioning

confidence: 99%

36-Year-Old Man With Productive Cough and Diffuse Rash

Kumar

Fadel

Beckman³

2006

Mayo Clinic Proceedings

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A 36-year-old farmer presented to his primary care physician for evaluation of cough with white sputum, pleuritic chest pain, and chills with rigors (maximum temperature, 38.9°C), all of 1 day's duration. While traveling to his local clinic, the patient also developed acute bilateral eye pain with redness, swelling, and discharge. His medical history was notable only for a fractured jaw. He had a 24pack-year history of smoking and had previously used methamphetamine. He was taking no medications or illegal drugs. He was divorced and denied recent sexual activity or travel. The patient's symptoms prompted his primary care physician to initiate antibiotic therapy.

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Respiratory Manifestations of Tick-Borne Diseases in the Southeastern United States

Cited by 19 publications

References 0 publications

An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side

An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side

Case 37-2001

36-Year-Old Man With Productive Cough and Diffuse Rash

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