A Guide to Tickborne Diseases in Minnesota

Disease Causative
Agent		 Incubation
Period		 Classic Clinical
Presentation		 Recommended
Laboratory Tests		 Recommended
Treatment
Lyme disease Borrelia
burgdorferi		 3-30 days Guidelines for MN Clinicians, Table 1
  • ELISA
  • Western Blot (if ELSA is positive or equivocal)
 Early Stage
Guideline, Table 3
Advanced Stage
Guideline, Table 4
Human Anaplasmosis, formerly known as human granulocytic ehrlichiosis Anaplasma phagocytophilum 7-21 days Symptoms include:
  • Acute onset of fever (above 102°) and/or chills
  • Headache
  • Myalgias
  • Decreased WBC
  • Decreased platelets
  • Increased liver enzymes
Less frequently seen:
  • Nausea, vomiting, anorexia
  • Cough
  • Diarrhea
  • Abdominal pain
  • Change in mental status

Two of the following:

  • IFA
  • PCR
  • Blood smear to
    visualize neutrophilic
    morulae
 Doxycycline until patient is afebrile for at least 3 days
Babesiosis Babesia microti Variable Gradual onset of:
  • Malaise
  • Anorexia
  • Fatigue
Followed acutely by:
  • Fever and/or chills
  • Myalgias / arthralgias
  • Nausea / vomiting
Other reported symptoms:
  • Hypotension
  • Renal failure
  • Decreased platelets
  • Decreased hemoglobin
  • IFA
  • PCR
  • Blood smear to visualize intraerythrocytic parasites
  • Consult with an infectious disease specialist
  • Quinine plus Clindamycin (severe cases)
  • Atovaquone plus Azithromycin
Rocky Mountain Spotted Fever Rickettsia rickettsii 2-14 days Abrupt onset of:
  • Fever
  • Headache
  • Myalgias
  • Nausea and vomiting
  • Rash (maculae on wrists and ankles, spreading then to trunk, face, palms and soles)
  • IFA
  • PCR
  • Isolation of R. rickettsii
  • Consult with an infectious disease specialist
  • Tetracyclines
  • Chloramphenicol

Updated Thursday, 18-Nov-2010 13:40:44 CST