Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States.

IF 33.7 1区 医学 Q1 Medicine Mmwr Recommendations and Reports Pub Date : 2016-05-13 DOI:10.15585/mmwr.rr6502a1
Holly M Biggs, Casey Barton Behravesh, Kristy K Bradley, F Scott Dahlgren, Naomi A Drexler, J Stephen Dumler, Scott M Folk, Cecilia Y Kato, R Ryan Lash, Michael L Levin, Robert F Massung, Robert B Nadelman, William L Nicholson, Christopher D Paddock, Bobbi S Pritt, Marc S Traeger
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引用次数: 349

Abstract

Tickborne rickettsial diseases continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of low-cost, effective antibacterial therapy. Recognition early in the clinical course is critical because this is the period when antibacterial therapy is most effective. Early signs and symptoms of these illnesses are nonspecific or mimic other illnesses, which can make diagnosis challenging. Previously undescribed tickborne rickettsial diseases continue to be recognized, and since 2004, three additional agents have been described as causes of human disease in the United States: Rickettsia parkeri, Ehrlichia muris-like agent, and Rickettsia species 364D. This report updates the 2006 CDC recommendations on the diagnosis and management of tickborne rickettsial diseases in the United States and includes information on the practical aspects of epidemiology, clinical assessment, treatment, laboratory diagnosis, and prevention of tickborne rickettsial diseases. The CDC Rickettsial Zoonoses Branch, in consultation with external clinical and academic specialists and public health professionals, developed this report to assist health care providers and public health professionals to 1) recognize key epidemiologic features and clinical manifestations of tickborne rickettsial diseases, 2) recognize that doxycycline is the treatment of choice for suspected tickborne rickettsial diseases in adults and children, 3) understand that early empiric antibacterial therapy can prevent severe disease and death, 4) request the appropriate confirmatory diagnostic tests and understand their usefulness and limitations, and 5) report probable and confirmed cases of tickborne rickettsial diseases to public health authorities.

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蜱传立克次体疾病的诊断和管理:落基山斑疹热和其他斑疹热组立克次体病,埃利希体病和无形体病-美国。
尽管有低成本、有效的抗菌治疗,但蜱传立克次体病继续在健康的成人和儿童中造成严重疾病和死亡。在临床过程的早期识别是至关重要的,因为这是抗菌治疗最有效的时期。这些疾病的早期体征和症状是非特异性的或类似于其他疾病,这可能使诊断具有挑战性。以前未被描述的蜱传立克次体疾病继续得到确认,自2004年以来,在美国又有三种病原体被描述为人类疾病的原因:白氏立克次体、默氏埃利希体样病原体和立克次体364D种。本报告更新了2006年美国疾病预防控制中心关于蜱传立克次体疾病诊断和管理的建议,并包括有关流行病学、临床评估、治疗、实验室诊断和预防蜱传立克次体疾病的实际方面的信息。疾病预防控制中心立克次体人患科与外部临床和学术专家以及公共卫生专业人员协商后,制定了本报告,以协助卫生保健提供者和公共卫生专业人员:1)认识到蜱传立克次体病的主要流行病学特征和临床表现;2)认识到多西环素是成人和儿童疑似蜱传立克次体病的首选治疗方法;3)了解早期经验性抗菌治疗可预防严重疾病和死亡,4)要求进行适当的确诊性诊断测试,并了解其有效性和局限性,5)向公共卫生当局报告可能和确诊的蜱传立克次体病病例。
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来源期刊
Mmwr Recommendations and Reports
Mmwr Recommendations and Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
36.00
自引率
0.00%
发文量
3
期刊介绍: The MMWR series of publications is published by the Office of Science, Centers for Disease Control and Prevention (CDC), U.S. The MMWR Recommendations and Reports contain in-depth articles that relay policy statements for prevention and treatment in all areas in the CDC’s scope of responsibility (e.g., recommendations from the Advisory Committee on Immunization Practices).
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