Tick-Borne Illness: A Diagnostic Approach for the Urgent Care Clinician (Infectious Disease CME and Pharmacology CME)

Points & Pearls Excerpt

• Lyme disease, Rocky Mountain spotted fever (RMSF), ehrlichiosis, anaplasmosis, and babesiosis account for 99% of all reported tick-borne illnesses in the US. Lyme disease is most common and RMSF has the highest case-fatality rate. Other known tick-borne illnesses in the US include tularemia, southern tick-associated rash illness (STARI), Rickettsia parkeri rickettsiosis, tick-borne relapsing fever, and viral diseases such as Powassan disease, Colorado tick fever, Heartland virus, and Bourbon virus.
• The geographical footprints of ticks and tick-borne illnesses have significantly expanded since 2000. There is overlap of the geographic footprints of anaplasmosis, babesiosis, and Lyme disease, as well as of the geographic footprints of RMSF and ehrlichiosis. (See Figure 1, Figure 2, Figure 3, and Figure 4.)
• Patients with a tick-borne illness may not recall a tick bite, so the lack of a tick or a known tick bite should not eliminate consideration for tick-borne illness. Many activities of daily living (yard work, hikes, playing with pets) can result in exposure to ticks.