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(Chest. 1999;116:222-230.)
© 1999 American College of Chest Physicians

Tick-Borne Pulmonary Disease*

Update on Diagnosis and Management

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

* From the Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Palo Alto, CA.

Correspondence to: Stephen J. Ruoss, MD, Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Palo Alto, CA 94305; e-mail: ruoss{at}leland.stanford.edu

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.

Key Words: Ehrlichia • Lyme • pulmonary • respiratory • tick • tularemia




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R. P. Byrd Jr., T. M. Roy, J. L. Faul, and S. J. Ruoss
Ehrlichiosis in the United States
Chest, May 1, 2000; 117(5): 1524 - 1525.
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