1、Vector-Borne Infectious Disease,Danielle Kruger,LYMES DISEASE,ETIOLOGY:,Borrelia burgdorferi,loosely coiled spirochete,LYMES DISEASE,Vector:,Ixodes scapularis: adult female, male, nymph, & larva on cm scale,Ixodid deer tick,LYMES DISEASE,Reservoir:,White-footed mouse White-tailed deer,LYMES DISEASE,
2、Localized rash: Erythema migrans,12-y/o girl presented to her PCP with a 6-cm circle of erythema with central clearing on the side of her neck. The patient lived in an area of Connecticut where Lyme disease is endemic. Diagnosed with erythema migrans and prescribed amoxicillin - after 20 days of ant
3、ibiotic therapy, the rash had enlarged and contained multiple rings. Thought she had erythema migrans unresponsive to amoxicillin therapy. The eruption was mildly pruritic, and the patient had no constitutional symptoms.,Seen in Pediatric ER We learn her family applying a high-potency topical steroi
4、d to her neck prescribed for someone else KOH prep: fungal hyphae Fungal culture: Trichophyton Be cognizant of differentials: erythema migrans is rarely scaly and resolves rapidly with appropriate oral antibiotic therapy (amoxicillin or doxycycline). “Tinea incognito“ - tinea infection modified by t
5、opical steroids; suppress local immune response allowing fungus to grow easily - bizarre appearance!,LYMES DISEASE,ROCKY MOUNTAIN SPOTTED FEVER,The most severe and most frequently reported rickettsial illness in the United States.,very small bacterium that must live inside the cells of its hosts,Ric
6、kettsia rickettsii,Microbe:,Vector:,Dermacentor tick (American dog tick),Typical petechial rash,Just for Comparison,Dermacentor tick (American dog tick),Ixodid deer ticks,TULAREMIA,Microbe:,TULAREMIA,Vector:,Ulcerating lymphadenitis,Ocular glandular,Ulceroglandular,CAT SCRATCH DISEASE,Microbe:,Barto
7、nella henselae,Vector:,CAT SCRATCH DISEASE,Localized papule & regional lymphadenopathy,MALARIA,Microbe:,Plasmodium falciparum Plasmodium malariae Plasmodium vivax Plasmodium ovale,Vector:,Anopheles mosquito,MALARIA,TREATMENT,Lymes disease:,Rocky Mountain Spotted fever:,Tularemia:,Cat Scratch disease:,Malaria:,Doxycycline, Tetracycline,Doxycycline, Tetracycline,Streptomycin, Gentamicin,Zithromax, Cipro,“Quines”,
