#rocky mountain spotted fever

[beautiful-ratsunset]

Fallis, OK

#these were taken like a year ago #when i visited i got bit by 39(!) ticks and got rocky mountain spotted fever #rocky mountain spotted fever #i had to pull 39 #not yet engorged #most thankfully very small #fucking ticks #TICKS #that was the sickest i’ve ever been #urban exploration #abandoned #american gothic #midwest gothic #oklahoma #etc etc

[dddemigirl]

#rocky mountain spotted fever #alpha-gal syndrome #alpha gal #AGS #RMSF #chronic illness #chronically ill #spoonie #invisible illness #invisible disease #invisible disability #fuck ticks #tw ticks #ask to tw

[psalm40speakstome]

#lyme disease #Lyme disease is real #Lyme #co infections #bartonella #babesia #rocky mountain spotted fever #etc… #neurological Lyme disease #neurological lyme #causes #christopher meloni #Youtube

[mcatmemoranda]

I took notes on tick borne illnesses one of the pharmacy residents gave. Very helpful.

#tickborne illnesses #anaplasmosis #babesia #lyme disease #lyme #ehrlichia #ehrlichiosis #RMSF #rocky mountain spotted fever #ticks

[spoonful116]

Tick bites aren't just itchy, they can carry some nasty diseases!

#spoonie #disability #tick safety #ticks #lyme disease #tickdisease #tick fever #rmsf #rocky mountain spotted fever #Ehrlichiosis #lyme #summer safety

[miasanmuller]

*opening up google to search for exotic diseases for my next 'I hope Tuchel gets [disease]' post*

#what do yall think of rocky mountain spotted fever? or pertussis?

[itsallwearecalledtodo]

fun fact if you live in pennsylvania you can order a tick analysis from ticklab.org and get a basic qPCR for free

#tests for lyme and rocky mountain spotted fever and a whole bunch of other stuff #the next level is $50 #it's through a university so it's not sketchy or anything

[crtter]

IS THAT A BLUE AND MOLDY TICK I SEE?? ON Y O U R PROFILE?? Pathetic. *beats you up* 👹👹👹👹👹👹👹 *blocks you and unfollowz* /j

Hey hey hey hey HEY! These two ticks were GIFTS, just like the beautiful target shaped rashes they’re leaving all over my skin.

#I’m just kidding I don’t have Lyme disease #over here ticks only give you Rocky Mountain spotted fever #answers #ohpuppetofmine

[viralarcadian]

going thru my first ever panic attack and it's not great gamers

#it started bc of a tick bite and me catastrophizing the worst possible outcome #which isnt lime disease bc its a wood tick but rocky mountain spotted fever #which has a hilariously low occurrence rate but my anxiety doesnt care #rmsf and tularemia too #which also has a hilariously low occurence rate

[llycaons]

If You Find a Tick in Your Home or on Your Skin do you Let it Live There (Normal) Or Kill it like Some Lunatic

#this one's for my upstate ny and west coast folks....you know lyme. rocky mountain spotted fever...etc #yes I know that a lot of stigma around 'dirty' animals like rats or pigs is false and they're perfectly clean animals #but you do not fuck around with ticks #actually maybe leeches are also my limit. I don't think they can give you any diseased but we always got rid of them #sorry :( #edit: NEVER MIND. leeches can transmit infected blood between people. not a safe animal! #cor.txt

[genderjester]

I love to listen and relisten to this podcast will kill u so much fr. Comfort podcast even tho the diseases they talk abt are obv often rly gnarly but i love. Microbiology and medical history<3

Also specifically relistening to the leishmaniasis episode made me once again go Ah! We should kill the profit driven pharma industry with hammers!

#its an odd mix sometimes between woah the like. biology of this disease is fascinating #and also being like well it is also absolutely awful and terrifying that ppl have to deal w those diseases #saw a poll going around a whiiile ago that was like haha whats ur favourite of these old timey diseases #and all of them but smallpox where things ppl are still dying from today #so like that left a rly bad taste in my mouth....like #the plague still exists...tuberculosis kills a lot of ppl a year...... #like idk man #anyways im rambling #sel talks #like i think intracellular bacteria are so cool but that does not mean rocky mountain spotted fever is cool

[flyonthewallmedstudent]

Q Fever

Aka, Query fever. What a weird name for a disease. Imagine telling people that's what you got.

in the 30s-40s, an Australian pathologist in QLD/Brisbane, came across an outbreak of the same or similar illness among abbatoir or slaughterhouse workers.

At the time, he called the disease "Q" fever or query as a temporary name until the pathogen could be identified. Unfortunately it stuck.

decades later, now nobel prize winner and virologist, MacFarlane Burnett isolated and identified the microbe responsible. I think this discovery contributed to his prize. i forget already.

Microbe responsible: Coxiella burnetti. Named for Burnett and HR Cox, the American bacteriologist who found the genus Coxiella where C burnetti falls under.

Initially they felt it was related to Rickettsia, responsible for Rocky Mountain Spotted Fever, but as science progressed, this was disproven.

Now for a Case Report

A 55 yo Italian man with a history of aortic valve replacement was diagnosed with pyrexia of unknown origin twice. Further signs included myalgias/splenomegaly/night sweats. The 2nd time he was admitted for PUO he deteriorated rather dramatically and was put on meropenem and teicoplanin.

A host of organisms was tested for on serological testing based on the man's travel and epidemiological history, all negative. Even a rheumatological panel was done, also less revealing. He also had a history of MGUS (a haem disoder), which is kind of a red herring here.

Cultures were negative, no vegetations were seen on a TTE - so they did consider IE. Which is an important differential for PUO.

Eventually a PET-CT was done (often favoured when investigations do not yield much for a sick patient with fevers), finally revealing a focus of infectious on his ascending aorta, where he'd also had previous surgery done. And in a round about way, they also further identified Coxiella Burnetti. He was treated doxycycline and hydroxychloroquine. As it's so rare in Italy, it wasn't really considered even though he mentioned rural travel.

Bottomline: Q Fever is an important consideration in the work up for culture negative IE. Further to this, always consider IE in the differentials for PUO particularly if they're at increased risk for IE (prosthetic valves, damaged valves, select congenital heart issues, previous IE). IE can present with night sweats, fevers, weight loss and splenomegaly. It can be insidious and chronic in nature. other risk factors can be more suggestive as we'll get into below.

Causative organism

Coxiella burnetti, it's a zoonoses - i.e. transmissible from animals. Special powers: very tough/hardy, can survive extreme environments (high temps and UV light etc.) over prolonged periods and is resistant to many common disinfectants/surface cleaners.

It's an intracellular pathogen and gram negative coccobacilli (PINK!)

name coccobaccili reminds me of cocopuffs.

it's mainly associated with farm animals, which the CDC so wholesomely displays on its website on Q fever (wtf).

goats, sheep, cattle typically (but many other animals, even birds, dogs and horses can be reservoirs)

in particular bodily fluids - amniotic fluid, placenta, faeces/urine, milk etc.

you can get it through unpasteurized milk and through inhaling it if it lands on dust in the area

ever visit a farm or petting zoo lately? OMG WASH YOU HANDS.

That said, it's typically inhaled in inorganic dust. You inhale it, it goes to the lungs, and then the bloodstream.

Increased risk for Coxiella burnetti (What to take on history of exposures and when to strongly consider it)

live on a farm or near one

exposure to a farm

work as a vet on a farm

farm worker, dairy workers, researchers on these animals/facilities

slaughterhouse/abbatoir

Also from CDC:

Clinical presentation

Most won't get sick after exposure and remain asymptomatic, a very small minority does. even though it is highly infectious.

incubation time is 2-3 weeks (consider this time in your history of exposure, did they work on the farm 2-3 weeks ago as opposed to yesterday).

Nonspecific acute infectious symptoms:

nonspecific systemic fevers/malaise/arthralgias/myalgias--> key is high fevers though and can be associated with headache and photophobia.

non specific GI - N/V/diarrhoea

respiratory ones - SOB or cough, consider it as atypical cause of community acquired pneumonia.

rare: hepatitis and jaundice (granulomatous) or encephalitis with neurological complications such as demyelinating disease or CN palsies, also haemolytic anaemia and HLH (yikes)

really it's the history of exposure that will lead you down the garden path to Q fever.

Chronic Q fever is perhaps worse, and can present as culture negative IE/PUO. Months/years later, as B symptoms as above above + LOW/LOA, night sweats. More likely to occur if you are predisposed for IE as above, have a weakened immune system for any reason, including pregnancy.

Chronic Q fever has a mortality of 10% if left untreated. About <5% of those with acute Q fever develop this if left untreated. Speculation is that it's more of an autoimmune process or abnormal immunological response to the bacteria.

To be honest, most who walk in the door with community acquired pneumonia get treated empirically for atypicals anyway, (standard course of doxycycline), so we hardly really ponder the question of Q fever in every patient. But if they present chronically and did not have atypical cover at the onset of acute symptoms, then it's something important to consider.

Other important conditions - can cause complications in pregnant women and 20% will get post Q fever syndrome. like chronic fatigue.

investigations

Serology! nice and easy. Look for IgG antibodies in the chronic presentation. Or PCR. Down side to serology - can take 2-3 days for the body to make said antibodies to the bacteria for detection. PCR can be done on any fluids/tissue sent.

Cultures useless, hence it fall under the umbrella of culture negative (hard to grow outside a host cell, it is an obligate intracellular pathogen).

Other hints on bloods (as serology/PCR takes time to return) - elevated or low platelet's, transaminitis with normal bili, opacities in CXR with hilar lymphadenopathy, CSF will show raised protein levels if done when encephalitis is suspected.

imaging can also support the diagnosis.. as illustrated by the case report.

Treatment

Acute disease - as standard for atypical bugs, doxycycline 100 mg BD for 14 days. Alternatives - TMP SMX or Clarithromycin.

Chronic Q fever or IE:

native valves: doxycycline and hydroxychloroquine (200 TDS) for 18 months

prosthetic: same but 24 months

why hydroxy: enhances the action of doxycycline (increases the pH of the phagolysosome)

Follow-up: look for 4 fold decrease in IGG

Sources:

CDC

Stat Pearls

Wiki as linked above

#australian history #medblr #medblrs #infectious disease #infectious diseases #q fever #coxiella #coxiella burnetti

[dddemigirl]

I’ve been diagnosed with Rocky Mountain spotted fever and Alpha-gal syndrome. I’m picking up antibiotics for the RMSF that should help with the bite on my leg. I am also getting epipens in case I have a reaction. I’m getting a medication for my heart that lowers my heartbeat and helps with anxiety! My nurse said that the Rocky Mountain spotted fever can also cause joint aches. Been there before! So I have to cut red meat from my diet which I’m sad about. Some people are so sensitive that they have reactions to anything that even touches red meat so I have to bring the epipen to meals with me. Molly (my nurse) tested me for lyme’s disease, rheumatoid arthritis as well as a few other immune disorders and I was negative.

#alexa rambles #fuck ticks #tick #ticks #rocky mountain spotted fever #alpha-gal syndrome #AGS #epipen #epipens #allergy #food mention #sickness mention #heart problems #spoonie

[psalm40speakstome]

#mood #valid #scary halloween #costumes #scary costumes #the real horror #Lyme #lyme disease #neurological lyme disease #Lyme awareness #Lyme spirochete #western medicine #Lyme disease awareness #neurological lyme #bartonella #babesia #Rocky Mountain spotted fever #etc… #tick borne illness #tick borne disease #co-infections #chronic Lyme #lyme warrior #mutiple systemic infectious disease syndrome

[beenjen]

Suppose, the more things change, the more things stay the same. Porch sitting, where only a few weeks back, I was doing the same on my birthday. My family made a really big effort to do it up, being the first without mom. It was special. It was peaceful.

When I was porch sitting those few weeks ago, I talked with my aunt Cindy, who had been running a fever and feeling unwell for over a week. I pushed her and my uncle to go to the doctor, and when she finally did, it lead to her being admitted to the hospital. Sad to say she succumbed to Rocky Mountain Spotted Fever - she just had too many other health conditions and this was one too many. She passed Sunday evening. The service is later today.

She taught me a love of the outdoors. Always gardening, knew every plant. We would go for walks in the woods and she would name off everything. I thought that was SO cool. She could grow anything - green thumb wasn’t an apt enough name, more like green arm. She loved to go camping. We went on Mission Trips - ran heath clinics there, built schools, taught about fresh water.

We had a special bond. She would always call me out on my crap. Without fail. If I was being a smart mouth to my mom as a teen - whoop, not when my aunt was there. She would nip it real quick - ‘I’ve had enough of your mouth young lady.’ She was a good, kind, gentle woman, who was firm in her beliefs. Accepting. Approachable. Available. Honest.

I will miss her xx

[spoonful116]

Bug off, bugs!

#summer safety #summer #tick safety #ticks #tickdisease #mosquito #mosquitoes #malaria #dengue fever #rmsf #lyme disease #rocky mountain spotted fever #fleas #flies #Ehrlichiosis #Babesiosis #plague #yellow fever #bugs #bug bites #insects #public health #epidemiology #infectious diseases