title: Arthropod-borne bacterial diseases in pregnancy.
abstract: Arthropod-borne bacterial diseases affect more than 25,000 Americans every year and thousands more around the world. These infections present a diagnostic dilemma for clinicians because they mimic many other pathologic conditions and are often low on or absent from the differential diagnosis list. Diagnosis is particularly challenging during pregnancy, as these infections may mimic common pregnancy-specific conditions, such as typical and atypical preeclampsia, or symptoms of pregnancy itself. Concerns regarding the safety in pregnancy of some indicated antibiotics add a therapeutic challenge for the prescriber, requiring knowledge of alternative therapeutic options for many arthropod-borne bacterial diseases. Physicians, especially those in endemic areas, must keep this class of infections in mind, particularly when the presentation does not appear classic for more commonly seen conditions. This article discusses presentation, diagnosis, and treatment of the most common of these arthropod-borne bacterial diseases, including Lyme disease, Rocky Mountain spotted fever, tick-borne relapsing fever, typhus, plague, cat-scratch disease, and Carrión disease.
authors.affiliation: Resident, Duke University.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Dotters-Katz
authors.affiliation: Professor of Obstetrics and Gynecology.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kuller
authors.affiliation: Associate Professor of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Duke University Medical Center, Durham, NC.
authors.forename: R Phillips
authors.initials: RP
authors.lastname: Heine
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001179:Arthropod Vectors; D002372:Cat-Scratch Disease / Q000175:diagnosis / Q000188:drug therapy; D016873:Ehrlichiosis / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis / Q000628:therapy; D010930:Plague / Q000175:diagnosis / Q000188:drug therapy; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy*; D012061:Relapsing Fever / Q000175:diagnosis / Q000188:drug therapy; D012288:Rickettsiaceae Infections / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents