EMCrit Project

IBCC chapter & cast: Tick-borne infections

It’s spring in Vermont… when a young intensivist’s thoughts go from fancy to tick-borne diseases.  Climate shifts are causing an increase in tick-borne illnesses, such that these are now considered emerging infections in many areas (including the northeast United States and Canada).  These diseases can be extremely difficult to diagnose, as they will often present with a nonspecific flu-like illness and may subsequently progress to multi-organ failure.  Misdiagnosis of a tick-borne illness as bacterial septic shock would lead to inadequate treatment, as these diseases require specific antibiotic therapy (usually doxycycline).  This chapter focuses on diagnosis and empiric therapy for these very challenging infections.