Last reviewed: 6 Nov 2021
Last updated: 21 May 2020

Summary

Definition

History and exam

Key diagnostic factors

  • history of tick bite/exposure
  • history of immunosuppression
  • fever
  • headache
  • malaise
  • myalgia
  • arthralgia
  • nausea
  • small erythematous lesion with or without necrotic center
  • nonspecific rash

Other diagnostic factors

  • vomiting
  • diarrhea
  • abdominal pain
  • cough
  • dyspnea
  • stiff neck
  • confusion
  • photophobia
  • stupor
  • coma
  • seizures
  • lymphadenopathy
  • jaundice
  • hepatomegaly
  • splenomegaly
  • secondary infections

Risk factors

  • tick bite/exposure
  • immunosuppression
  • age over 60 years
  • male sex

Diagnostic investigations

Investigations to consider

  • immunofluorescence antibody assay
  • polymerase chain reaction

Emerging tests

  • Western immunoblotting
  • culture
  • immunohistochemistry

Treatment algorithm

Contributors

Authors

Juan P. Olano, MD

Professor

Department of Pathology

University of Texas Medical Branch

Galveston

TX

Disclosures

JPO is the author of a number of references cited in this topic.

Peer reviewers

Linda S. Nield, MD

Associate Professor of Pediatrics

West Virginia University School Of Medicine

Morgantown

WV

Disclosures

LSN declares that she has no competing interests.

Richard Reithinger, MD, PhD

Professor

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

RR declares that he has no competing interests.

Use of this content is subject to our disclaimer