Now that our month of point of care ultrasound (POCUS) is over, it is time to talk about other clinically relevant topics. Michelle Perkins is back again this time to help us cover tickborne illnesses in the United States.
General Workup and Diagnosis
Disseminated illness: all bets are off. This is where you see the weird stuff. You can see multiple bullseyes, flu symptoms, and rheumatologic manifestations like migratory joint pain, muscle pain, and bone pain. You can see cardiac manifestations, like AV nodal block, myocarditis, and pericarditis. And the neuro stuff can be deceptive—you can see meningitis or even encephalitis, you can see neuropathy, Bell’s palsy, and/or cognitive issues. As far as labwork, you may see an elevated ESR/WBC, but generally not much acutely. Lyme serology is negative for the first few weeks, so not helpful in that window. You also can’t distinguish between active and past infection with serology. So you can’t use testing to measure treatment response.
Rocky Mountain Spotted Fever
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