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Colorado Tick Fever Treatment & Management

  • Author: Cassis Thomassin, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
 
Updated: Jan 21, 2016
 

Approach Considerations

Emergency department (ED) care of patients with Colorado tick fever is the same as that for any patient with a febrile illness. The essential decision is whether a serious treatable infection exists; history taking and physical examination must be directed toward this issue. Exclusion of the treatable infections listed in the differential diagnosis, as well as any other serious bacterial infection, is the goal of care. Administration of fluids and antipyretics as needed is indicated. Consultation with an infectious disease specialist may be appropriate in some cases.

If a tick is found to be still attached to the patient, it must be removed. The removal method that is generally recommended is to grasp the tick with a forceps or fine-point tweezers near the point of attachment and then to pull straight outward with steady, even, gentle traction. Twisting and squeezing should be avoided, because they may facilitate the movement of pathogens into the host and may be more likely to leave tick mouthparts embedded in the skin.[9]

Patients diagnosed with Colorado tick fever should continue antipyretic therapy. They should be instructed to follow up with a primary care physician and to refrain from donating blood or bone marrow for at least 6 months after infection. The emergency physician should be aware that weakness and fatigue caused by this illness may last for several weeks.[1]

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Prevention

For individuals who are planning to spend extended periods of time outside in endemic areas, the following precautions are appropriate:

  • Wear a long-sleeve shirt, and tuck the shirt into the pants
  • Tuck the pant legs into the socks
  • Wear light-colored clothing
  • Perform daily tick checks
  • Apply insect repellent such as DEET or permethrin [10]
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Contributor Information and Disclosures
Author

Cassis Thomassin, MD Clinical Assistant Instructor, Resident Physician, Department of Emergency Medicine, SUNY Downstate Medical Center

Cassis Thomassin, MD is a member of the following medical societies: American College of Emergency Physicians, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

Coauthor(s)

Ninfa Mehta, MD, MPH Clinical Assistant Professor, Ultrasound Fellowship Director, Department of Emergency Medicine, Kings County Hospital, State University of New York Downstate Medical Center

Ninfa Mehta, MD, MPH is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Medical Student Association/Foundation, Society for Academic Emergency Medicine, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.

Chief Editor

Jeter (Jay) Pritchard Taylor, III, MD Assistant Professor, Department of Surgery, University of South Carolina School of Medicine; Attending Physician, Clinical Instructor, Compliance Officer, Department of Emergency Medicine, Palmetto Richland Hospital

Jeter (Jay) Pritchard Taylor, III, MD is a member of the following medical societies: American Academy of Emergency Medicine, South Carolina Medical Association, Columbia Medical Society, South Carolina College of Emergency Physicians, American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Chief Editor for Medscape.

Additional Contributors

Massoud G Kazzi, MD Fellow, Department of Critical Care Medicine, Montefiore Medical Center

Disclosure: Nothing to disclose.

Acknowledgements

Dan Danzl, MD Chair, Department of Emergency Medicine, Professor, University of Louisville Hospital

Dan Danzl, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Kentucky Medical Association, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Jonathan A Edlow, MD Associate Professor of Medicine, Department of Emergency Medicine, Harvard Medical School; Vice Chairman, Department of Emergency Medicine, Beth Israel Deaconess Medical Center

Jonathan A Edlow, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Jon Mark Hirshon, MD, MPH Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine

Jon Mark Hirshon, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

References
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  8. Crowder CD, Rounds MA, Phillipson CA, et al. Extraction of total nucleic acids from ticks for the detection of bacterial and viral pathogens. J Med Entomol. 2010 Jan. 47(1):89-94. [Medline]. [Full Text].

  9. Wilson ME. Prevention of tick-borne diseases. Med Clin North Am. 2002 Mar. 86(2):219-38. [Medline].

  10. Centers for Disease Control and Prevention. Colorado Tick Fever: Prevention. Available at http://www.cdc.gov/coloradotickfever/prevention.html. January 13, 2015;

  11. Lindquist L, Vapalahti O. Tick-borne encephalitis. Lancet. 2008 May 31. 371 (9627):1861-71. [Medline].

  12. Centers for Disease Control and Prevention (CDC). Tick-borne encephalitis among U.S. travelers to Europe and Asia - 2000-2009. MMWR Morb Mortal Wkly Rep. 2010 Mar 26. 59 (11):335-8. [Medline].

  13. Centers for Disease Control and Prevention. National notifiable diseases surveillance system (NNDSS). Case definitions. Available at http://wwwn.cdc.gov/nndss/script/casedefDefault.aspx. Accessed: August 3, 2015.

  14. Heinz FX, Stiasny K, Holzmann H, Grgic-Vitek M, Kriz B, Essl A, et al. Vaccination and tick-borne encephalitis, central Europe. Emerg Infect Dis. 2013 Jan. 19 (1):69-76. [Medline].

  15. Arrigo NC, Adams AP, Weaver SC. Evolutionary patterns of eastern equine encephalitis virus in North versus South America suggest ecological differences and taxonomic revision. J Virol. 2010 Jan. 84 (2):1014-25. [Medline].

  16. Kaiser R. Tick-borne encephalitis. Infect Dis Clin North Am. 2008 Sep. 22 (3):561-75, x. [Medline].

 
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Two ticks next to common match. On right is Ixodes scapularis, vector for Lyme disease. On left is Dermacentor tick (the larger one and the vector for Colorado tick fever).
 
 
 
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