HENGITYSTIEONGELMAT

[Bb]

Lähettäjä: Soijuv Lähetetty: 17.8.2004 11:49

Punkkien pureman myötä elimistöön joutuu useita taudinaiheuttajia (bakteereja, viruksia jne.) ja useat niistä voivat aiheuttaa erilaisia hengitystieongelmia.


http://www.aafp.org/afp/20010515/1969.html


Severe babesiosis in Long Island: review of 34 cases and their complications.

Hatcher JC, Greenberg PD, Antique J, Jimenez-Lucho VE.

Division of Infectious Diseases, Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY 11794-8153, USA.

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract



Tick-Borne Pulmonary Disease - Update on Diagnosis and Management


from CHEST

John L. Faul, MD; Ramona L. Doyle, MD, FCCP; Peter N. Kao, MD; and Stephen J. Ruoss, MD

http://www.medscape.com/viewarticle/416978?src=search

Tick-Borne Pulmonary Disease - Update on Diagnosis and Management

from CHEST

John L. Faul, MD; Ramona L. Doyle, MD, FCCP; Peter N. Kao, MD; and Stephen J. Ruoss, MD

Abstract and Introduction
Abstract

Ticks are capable of transmitting viruses, bacteria, protozoa, and rickettsiae to man. Several of these tick-borne pathogens can lead to pulmonary disease. Characteristic clinical features, such as erythema migrans in Lyme disease, or spotted rash in a spotted fever group disease, may serve as important diagnostic clues. Successful management of tick-borne diseases depends on a high index of suspicion and recognition of their clinical features. Patients at risk for tick bites may be coinfected with two or more tick-borne pathogens. A Lyme vaccine has recently become available for use in the United States. Disease prevention depends on the avoidance of tick bites. When patients present with respiratory symptoms and a history of a recent tick bite or a characteristic skin rash, a differential diagnosis of a tick-borne pulmonary disease should be considered. Early diagnosis and appropriate antibiotic therapy for these disorders lead to greatly improved outcomes.

Introduction

In the United States and Europe, more vector-borne diseases are transmitted to humans by ticks than by any other agent.[1] In addition to neurotoxins, ticks can transmit bacteria, rickettsiae, spirochetes, viruses, and protozoa.[2] Some tick-borne diseases, such as Lyme disease [3,4] and ehrlichiosis, can cause severe or fatal illnesses.[5,6] Cardiopulmonary complications associated with tick-borne diseases are particularly serious and may be life-threatening.[5,7] If a patient presents with pulmonary symptoms and gives a history of a recent tick bite, a pulmonary complication caused by a tick-borne disease should be considered in the differential diagnosis (Table 1). When left undiagnosed or untreated, these disorders can be crippling or fatal.[5,7,8]

Many species of ticks that have been found over a very wide geographic distribution [9-11] may transmit diseases to humans (Table 2). Ticks are obligate blood-sucking arthropods (Figs 1 and 2) that transmit pathogens while feeding.[11] Large reservoirs of ticks feed on the rodents and small mammals that inhabit wooded areas, gardens, and parklands.[12,13] Nevertheless, outbreaks of tick-borne diseases are not confined to rural areas. Successful management of tick-borne diseases depends on a high index of suspicion and an awareness of their geographic epidemiology and clinical features.[3,8] Tick-borne diseases have protean manifestations. Patients at risk for tick bites may harbor two or more concurrent tick-borne infections. [14] The diagnosis of a tick-borne disease is most often based on a constellation of clinical signs and a history of outdoor pursuits, skin rash, or tick bites. [3,9,10]

Effective therapy is available for most tick-borne diseases.[2,8] The emergence of Lyme disease and ehrlichiosis has led to a heightened public and physician awareness of the importance of tick-borne diseases.[1,2] In recent years, there has been an increased reporting of tick bites by patients and a real increase in the diagnosis of tick-borne illnesses. Serologic testing appears to be useful in appropriate clinical settings, and it has become widely available so that physicians can confirm infection by the more common tick-borne pathogens.[1]

This article reviews the pulmonary manifestations of four major tick-borne diseases: Lyme disease, ehrlichiosis, tularemia, and Rocky Mountain spotted fever (RMSF). The clinical features and treatment options for tick-borne diseases are outlined in order to improve the diagnostic evaluation and clinical management of patients presenting with respiratory complaints and a history of a tick bite.