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 (30524954). 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, because these diseases require specific antibiotic therapy (usually doxycycline). This chapter focuses on diagnosis and empiric therapy for these very challenging infections.
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The IBCC chapter is located here.
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Great post, as usual. I didn’t see any mention of the Maltese cross pattern that can be seen in babesiosis smears. This is featured in the cdc write-up on the laboratory diagnosis here:
https://www.cdc.gov/dpdx/resources/pdf/benchAids/Babesia_benchaid.pdf
Additionally, for completeness sake, you mention anaplasmosis potentially causing rhabdo and needing to check a CK, yet there is no mention of anaplasmosis in your rhabdo IBCC chapter.
Ben D.
Can add blood transfusions as an exposure for babesia: https://www.cdc.gov/parasites/babesiosis/resources/babesiosis_policy_brief.pdf