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Tick-Borne Diseases, Colorado: Treatment & Medication
Updated: Dec 9, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Treatment
Emergency Department Care
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. Therefore, history taking and physical examination must be directed toward this issue. Exclusion of treatable infections listed in the differential diagnosis section, as well as any other serious bacterial infection, is the goal of ED care. Administration of fluids and antipyretics as needed is indicated.
Consultations
Consultation with an infectious disease specialist may be appropriate in some cases.
Medication
No specific treatment exists for Colorado tick fever. Regular use of antipyretics provides symptomatic relief. Although ribavirin has some activity against the virus in animal experiments, no human data exist.
Antipyretics
Treatment of Colorado tick disease is symptomatic and supportive. Bed rest and mild analgesic-antipyretic therapy often is helpful in relieving associated lethargy, malaise, and fever.
Aspirin (Bayer Aspirin, Anacin, Ascriptin, Bufferin)
Lowers elevated body temperature by vasodilating peripheral vessels, enhancing dissipation of excess heat. Also acts on the heat-regulating center of the hypothalamus to reduce fever.
Adult
325-650 mg PO q4-6h; not to exceed 4 g/d
Pediatric
10-15 mg/kg/dose PO q4-6h; not to exceed 60-80 mg/kg/d
Effects may decrease with antacids and urinary alkalinizers; corticosteroids decrease salicylate serum levels; additive hypoprothrombinemic effects and increased bleeding time may occur with coadministration of anticoagulants; may antagonize uricosuric effects of probenecid and increase toxicity of phenytoin and valproic acid; doses >2 g/d may potentiate glucose-lowering effect of sulfonylurea drugs
Documented hypersensitivity; liver damage; hypoprothrombinemia; vitamin K deficiency; bleeding disorders; asthma; children (<16 y) with flu (association with Reye syndrome)
Pregnancy
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus
Precautions
May cause transient decrease in renal function and aggravate chronic kidney disease; avoid in severe anemia, history of blood coagulation defects, anticoagulant therapy
Ibuprofen (Motrin, Advil, Nuprin, Ibuprin)
One of the few NSAIDs indicated for reduction of fever.
Adult
200-400 mg PO q4-6h while symptoms persist; not to exceed 3.2 g/d
Pediatric
<6 months: Not established
6 months to 12 years: 30-70 mg/kg/d PO divided tid/qid; start with lower dose and titrate to maximum of 2.4 g/d
>12 years: Administer as in adults
Coadministration with aspirin increases risk of inducing serious NSAID-related adverse effects; probenecid may increase concentrations and, possibly, toxicity of NSAIDs; may decrease effect of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; monitor PT closely (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently
Documented hypersensitivity; peptic ulcer disease; recent GI bleeding or perforation; renal insufficiency; high risk of bleeding
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
D - Fetal risk shown in humans; use only if benefits outweigh risk to fetus
Precautions
Caution in congestive heart failure, hypertension, and decreased renal and hepatic function; caution in anticoagulation abnormalities or during anticoagulant therapy
Acetaminophen (Tylenol, Anacin Free Aspirin, Feverall)
Reduces fever by directly acting on hypothalamic heat-regulating centers, which increases dissipation of body heat with vasodilation and sweating.
Adult
325-650 mg PO q4-6h or 1000 mg tid/qid; not to exceed 4 g/d
Pediatric
<12 years: 10-15 mg/kg/dose PO q4-6h prn; not to exceed 2.6 g/d
>12 years: 325-650 mg PO q4h; not to exceed 5 doses in 24 h
Rifampin can reduce analgesic effects; coadministration with barbiturates, carbamazepine, hydantoins, and isoniazid may increase hepatotoxicity
Documented hypersensitivity; known G-6-PD deficiency
Pregnancy
B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals
Precautions
Hepatotoxicity possible in chronic alcoholics following various dose levels; severe or recurrent pain or high or continued fever may indicate a serious illness; many OTC products contain acetaminophen and combined use with these products may cause cumulative acetaminophen doses to exceed recommended maximum dose
More on Tick-Borne Diseases, Colorado |
| Overview: Tick-Borne Diseases, Colorado |
| Differential Diagnoses & Workup: Tick-Borne Diseases, Colorado |
 Treatment & Medication: Tick-Borne Diseases, Colorado |
| Follow-up: Tick-Borne Diseases, Colorado |
| Multimedia: Tick-Borne Diseases, Colorado |
| References |
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References
Emmons RW. Ecology of Colorado tick fever. Annu Rev Microbiol. 1988;42:49-64. [Medline].
Goodpasture HC, Poland JD, Francy DB, et al. Colorado tick fever: clinical, epidemiologic, and laboratory aspects of 228 cases in Colorado in 1973-1974. Ann Intern Med. Mar 1978;88(3):303-10. [Medline].
Klasco R. Colorado tick fever. Med Clin North Am. Mar 2002;86(2):435-40, ix. [Medline].
Leiby DA, Gill JE. Transfusion-transmitted tick-borne infections: a cornucopia of threats. Transfus Med Rev. Oct 2004;18(4):293-306. [Medline].
Romero JR, Simonsen KA. Powassan encephalitis and colorado tick fever. Infect Dis Clin North Am. Sep 2008;22(3):545-59, x. [Medline].
Spruance SL, Bailey A. Colorado Tick Fever. A review of 115 laboratory confirmed cases. Arch Intern Med. Feb 1973;131(2):288-93. [Medline].
Further Reading
Keywords
tick-borne diseases, Colorado tick fever, tick bite, Dermacentor andersoni, D andersoni, Orbivirus, vector-borne disease, wood tick, Coltivirus, RNA virus, tick-borne viral diseases, tick-borne virus, Rocky Mountain spotted fever, tick bite, viral infection
