小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
其他诊断因素
- 全身性症状
- 发热
- 黄疸
- 肝脾肿大
- 瘀点、指甲下裂片形出血或瘀斑
- 小便黄赤
- 结膜充血
- 咳嗽
- 咽痛
- 畏光
危险因素
- 该病流行区的居民或旅客
- 接触肩突硬蜱蜱虫
- 输血
- 无脾
- 免疫抑制
- 年龄＞50 岁
- 莱姆病
- 人粒细胞无形体病
- 妊娠期孕妇感染
诊断性检查
首要检查
- 外周血样涂片（Giemsa 或 Wright 染色）
- 巴贝虫 DNA 聚合酶链反应
- 全血细胞计数（FBC）
- 血清肌酐和尿素氮
- 肝功能检查 (LFT)
- 尿液分析
- ELISA 和/或免疫荧光方法检查莱姆病
- 针对人粒细胞无形体病的聚合酶链反应和/或免疫荧光检测或血沉棕黄层涂片
需考虑的检查
- 对田鼠巴贝虫进行间接免疫荧光抗体测定
- IgG/IgM 免疫印迹检测莱姆病
- HIV 血清学
治疗流程
无症状性明确感染
轻至中度疾病
急性重度疾病
复发性或难治性疾病
撰稿人
作者
Sarah Hochman, MD
Assistant Professor
Department of Medicine
Division of Infectious Diseases and Immunology
New York University School of Medicine
New York
NY
利益声明
SH declares that she has no competing interests.
Louis Weiss, MD, MPH
Professor of Medicine
Division of Infectious Diseases
Professor of Pathology
Division of Parasitology and Tropical Medicine
Albert Einstein College of Medicine
Bronx
NY
利益声明
LW has received grant funding from the National Institute of Allergy and Infectious Diseases. He is also the author of references cited in this topic.
同行评议者
Jeremy Gray, BSc, MSc, PhD
Professor
Department of Environmental Resource Management
University College Dublin
Belfield
Dublin
Republic of Ireland
利益声明
JG declares that he has no competing interests.
Sam Telford III, ScD
Associate Professor of Biomedical Sciences
Division of Infectious Diseases
Cummings School of Veterinary Medicine
Tufts University
Boston
MA
利益声明
ST has active research funding from the NIH. ST is an author or co-author of numerous primary publications on the biology of babesiosis, as well as reviews that have been referenced in this topic.
Raymond J. Dattwyler, MD
Professor of Medicine and Microbiology/Immunology
Chief of Allergy, Immunology and Rheumatology
New York Medical College
Valhalla
NY
利益声明
RJD declares that he has no competing interests.
鉴别诊断
- 莱姆病
- 人粒细胞无形体病
- 落矶山斑点热
更多 鉴别诊断指南
- 美国的蜱传播疾病：医疗保健提供者参考手册
- 2020 年巴贝虫病诊断和管理指南
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莱姆病
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更多 患者教育信息
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