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Tick-Borne Pulmonary Disease*: Update on Diagnosis and Management

John L. Faul, MD; Ramona L. Doyle, MD, FCCP; Peter N. Kao, MD; Stephen J. Ruoss, MD
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*From the Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Palo Alto, CA.

Correspondence to: Stephen J. Ruoss, MD, Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Palo Alto, CA 94305; e-mail: ruoss@leland.stanford.edu



Chest. 1999;116(1):222-230. doi:10.1378/chest.116.1.222
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Ticks are capable of transmitting viruses, bacteria, protozoa, and rickettsiae to man. Several of these tick-borne pathogens can lead to pulmonary disease. Characteristic clinical features, such as erythema migrans in Lyme disease, or spotted rash in a spotted fever group disease, may serve as important diagnostic clues. Successful management of tick-borne diseases depends on a high index of suspicion and recognition of their clinical features. Patients at risk for tick bites may be coinfected with two or more tick-borne pathogens. A Lyme vaccine has recently become available for use in the United States. Disease prevention depends on the avoidance of tick bites. When patients present with respiratory symptoms and a history of a recent tick bite or a characteristic skin rash, a differential diagnosis of a tick-borne pulmonary disease should be considered. Early diagnosis and appropriate antibiotic therapy for these disorders lead to greatly improved outcomes.

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