Emerging and Re-emerging Tick-Transmitted Rickettsial and Ehrlichial Infections

David H. Walker, Christopher D. Paddock, J. Stephen Dumler

Research output: Contribution to journalReview articlepeer-review

77 Scopus citations


Recently in the field of rickettsiology, an explosion of new isolates of pathogens have received species designation and new disease names, all of which have been relatively neglected by primary care and infectious disease physicians. A broad group of other tick-associated rickettsial and ehrlichial agents of unknown pathogenicity exist (eg, R amblyommii) that may cause confusion in interpreting serologic surveys or a single elevated antibody titer. Rickettsial and ehrlichial diseases are remarkable for their uniform susceptibility to doxycycline but are clinically difficult to distinguish from many viral infections and each another, and therefore misdiagnosis and failure to treat have unfortunate and sometimes tragic outcomes. Globally, many of these bacteria have been named but the genetic differences among them are often small, and many of their clinical manifestations may not be distinguishable diagnostically.

Original languageEnglish (US)
Pages (from-to)1345-1361
Number of pages17
JournalMedical Clinics of North America
Issue number6
StatePublished - Nov 2008


  • Ehrlichia ewingii
  • Human granulocytotropic anaplasmosis
  • Human monocytotropic ehrlichiosis
  • Rickettsia parkeri
  • Rocky Mountain spotted fever
  • Typhus

ASJC Scopus subject areas

  • General Medicine


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