Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- history of tick bite
Otros factores de diagnóstico
- constitutional symptoms
- pyrexia
- bradycardia
- jaundice
- hepatosplenomegaly
- petechiae, splinter hemorrhages, or ecchymoses
- dark urine
- conjunctival injection
- cough
- sore throat
- photophobia
Factores de riesgo
- residence in or travel to an endemic region
- exposure to Ixodes scapularis ticks
- asplenia
- immunosuppression
- blood transfusion
- age >50 years
- Lyme disease
- human granulocytic anaplasmosis
- maternal infection during pregnancy
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- peripheral blood smear (Giemsa or Wright stained)
- polymerase chain reaction (PCR) for babesial DNA
- CBC
- LFTs
- serum creatinine and blood urea nitrogen (BUN)
- urinalysis
- enzyme-linked immunosorbent assay (ELISA) and/or immunofluorescence assay for Lyme disease
- polymerase chain reaction (PCR) and/or immunofluorescence assay or buffy coat smear for human granulocytic anaplasmosis (HGA)
Pruebas diagnósticas que deben considerarse
- indirect immunofluorescence antibody assay for Babesia microti
- IgG/IgM immunoblot for Lyme disease
- HIV serology
- serum LDH
Algoritmo de tratamiento
asymptomatic documented infection
mild to moderate disease
acute severe disease
recurrent or refractory disease
Colaboradores
Autores
Sarah Hochman, MD
Assistant Professor
Department of Medicine
Division of Infectious Diseases and Immunology
New York University School of Medicine
New York, NY
Divulgaciones
SH declares that she has no competing interests.
Louis M. Weiss, MD, MPH

Professor, Department of Pathology
Professor, Department of Medicine (Infectious Diseases)
Albert Einstein College of Medicine
Bronx, NY
Divulgaciones
LMW has received grant funding from the National Institutes of Health for research on Toxoplasma gondii and microsporidiosis. LMW receives training grants for infectious diseases at the Albert Einstein College of Medicine, and serves on the board of the Humane Society of Westchester.
Revisores por pares
Cheston B. Cunha, MD
Associate Professor of Medicine
Warren Alpert Medical School of Brown University
Medical Director of the Antimicrobial Stewardship Programs
Rhodes Island Hospital and Miriam Hospital
Providence, RI
Divulgaciones
CBC declares that he has no competing interests.
Jeremy Gray, BSc, MSc, PhD
Professor
Department of Environmental Resource Management
University College Dublin
Belfield
Dublin
Republic of Ireland
Divulgaciones
JG declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Centers for Disease Control and Prevention. Tickborne diseases of the United States: a reference manual for health care providers, sixth edition. Aug 2022 [internet publication].Texto completo
Krause PJ, Auwaerter PG, Bannuru RR, et al. Clinical practice guidelines by the Infectious Diseases Society of America (IDSA): 2020 guideline on diagnosis and management of babesiosis. Clin Infect Dis. 2021 Jan 27;72(2):e49-64.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales
- Lyme disease
- Human granulocytic anaplasmosis
- Rocky Mountain spotted fever
Más DiferencialesGuías de práctica clínica
- Tickborne diseases of the United States: a reference manual for health care providers
- Clinical practice guidelines by the Infectious Diseases Society of America (IDSA): 2020 guideline on diagnosis and management of babesiosis
Más Guías de práctica clínicaInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
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