Last reviewed: August 2020
Last updated: 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
More investigations to consider

Emerging tests

  • Western immunoblotting
  • culture
  • immunohistochemistry
More emerging tests

Treatment algorithm

Contributors

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 reviewersVIEW ALL

Associate Professor of Pediatrics

West Virginia University School Of Medicine

Morgantown

WV

Disclosures

LSN declares that she has no competing interests.

Professor

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

RR declares that he has no competing interests.

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