Journal
MEDICAL CLINICS OF NORTH AMERICA
Volume 92, Issue 6, Pages 1345-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.mcna.2008.06.002
Keywords
Rocky Mountain spotted fever; Human monocytotropic ehrlichiosis; Rickettsia parkeri; Ehrlichia ewingii; Human granulocytotropic anaplasmosis; Typhus
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Recently in the field of rickettsiology, an explosion of new isolates of pathogens have received species designation and new disease names, all of which have been relatively neglected by primary care and infectious disease physicians. A broad group of other tick-associated rickettsial and ehrlichial agents of unknown pathogenicity exist (eg, P amblyommii) that may cause confusion in interpreting serologic surveys or a single elevated antibody titer. Rickettsial and ehrlichial diseases are remarkable for their uniform susceptibility to doxycycline but are clinically difficult to distinguish from many viral infections and each another, and therefore misdiagnosis and failure to treat have unfortunate and sometimes tragic outcomes. Globally, many of these bacteria have been named but the genetic differences among them are often small, and many of their clinical manifestations may not be distinguishable diagnostically.
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