Recognition of and Prompt Treatment for Tick-Borne Infections in Children

Mukkada, Sheena; Buckingham, Steven C.

doi:10.1016/j.idc.2015.05.002

Cited by 19 publications

(18 citation statements)

References 33 publications

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“…Similarly, the symptoms associated with TBDs coincide with those reflected in other studies [1–4]. In summary, the symptomatology described is highly unspecific, with fever as the most frequent symptom.…”

Section: Discussionsupporting

confidence: 84%

Hospitalisation by tick-borne diseases in the last 10 years in two hospitals in South Spain: analysis of tick exposure data collected in the Emergency Department

et al. 2019

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Tick-borne diseases (TBDs) can sometimes cause severe symptoms and lead to hospitalisation, but they often go unnoticed in the Emergency Department (ED). The aim of this study was twofold: (i) to describe the profile of patients hospitalised by TBDs; and (ii) to evaluate the data collected in the medical records from the ED in order to analyse their potential clinical consequences. A total of 84 cases that included all TBD diagnoses registered in the ED records were identified and analysed. These corresponded to all the hospitalisations by TBDs in the last 10 years (2009–2019) in two tertiary hospitals in Granada, Spain. Statistical analyses were made using RStudio. Coinciding with the absence of patient's report of exposure to ticks, 64.3% of TBDs were not suspected in the ED. Intensive care unit admission was required in 8.3% of cases, and the mortality rate was 2.4%. Non-suspected cases showed longer hospital stay (P < 0.001), treatment duration (P = 0.02) and delay in the initiation of antibiotic treatment (P < 0.001). Our findings indicate that symptoms associated with TBDs are highly non-specific. In the absence of explicit information related to potential tick exposure, TBDs are not initially suspected. As a consequence, elective treatment administration is delayed and hospitalisation time is prolonged. In conclusion, our results highlight the importance of addressing potential exposure to ticks during the ED contact with patients presenting with febrile syndrome.

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Section: Discussionsupporting

confidence: 84%

Hospitalisation by tick-borne diseases in the last 10 years in two hospitals in South Spain: analysis of tick exposure data collected in the Emergency Department

et al. 2019

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“…El exantema de FMRR tiene una progresión centrípeta desde las muñecas y tobillos hacia los brazos, piernas y tronco [2,3,14]. También es importante considerar que el exantema en FMRR puede ocurrir hasta el 4-5° día de evolución, aunque como se señaló no es necesaria su aparición para iniciar el tratamiento antibiótico [2,14,18].…”

Section: Discussionunclassified

Fiebre Manchada Y Su Potencial Coinfección Con Otras Enfermedades Transmitidas Por Vector

et al. 2017

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La fiebre manchada por Rickettsia rickettsii (FMRR) es una enfermedad reemergente transmitida en México por las garrapatas Rhipicephalus sanguineus infectadas por la bacteria homónima. Presentamos 3 casos fatales que cumplieron con criterios de compatibilidad para FMRR, y que al tener un resultado positivo para Dengue o Chikungunya no se solicitó prueba confirmatoria para FMRR o se hizo en días de evolución clínica donde es poco probable encontrar elevación de anticuerpos específicos contra la bacteria. Si bien existe una similitud en el cuadro clínico y de laboratorio entre FMRR y padecimientos febriles exantemáticos endémicos en Sonora, hay datos clínicos, de laboratorio y epidemiológicos que podrían guiar al médico clínico a sospechar de la enfermedad, incluso en presencia de una prueba positiva confirmatoria de algún otro padecimiento. Esta serie de casos es una llamada a estructurar protocolos de estudio en pacientes con enfermedades febriles exantemáticas en regiones endémicas de FMRR como Sonora.

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“…The clinical triad of fever, rash, and history of tick exposure is present in 3% to 18% of patients at their first visit . Lack of a rash is a known predictor of therapeutic delay . In our study, four of six patients presented with rash and fever during peak tick activity months; none were given doxycycline.…”

Section: Discussionmentioning

confidence: 99%