#EMConf: Management of Tick Borne Illnesses
Thu, 11/01/2018 - 7:00am
Consider tick borne illness when:
- Influenza-like illness presentations, especially during the summer months.
- Fever of unknown origin
- When viral meningitis is on your differential diagnosis.
- PO: Atovaquone + Azithromycin
- IV: Clindamycin + Quinine
- Exchange transfusion indications (would need Hematology/Oncology consult): 1. Asplenia 2. Parasite Load > 10%
- Doxycycline for early localized or early disseminated disease
- If under 8 years old or allergy, can do Amoxicillin
- if high degree AV Block or Meningitis - IV Ceftriaxone
- Lyme prophylaxis with 200 mg Doxy x 1 dose; Amoxicillin not effective
- Attached x 36h; based on engorgement size
- Lyme endemic area (local infection rate > 20%)
- Treatment within 72h of tick removal
- No Doxycycline contraindication
Erhlichiosis and Anaplasmosis:
- Doxycycline regardless of age.
- Rifampin if life-threatening allergy or pregnant
Tularemia (not always tickborne):
- Streptomycin or Gentamycin.