Babesiosis differential diagnosis: Difference between revisions

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*Q fever
*Q fever
*Leptospirosis
*Leptospirosis
==Differentiating Babesiosis from other tick-borne Diseases==
The following are tables differentiating tick-borne illnesses, categorized according to an underlying bacterial, viral, or protozoan infection:
===Bacterial===
{| class="wikitable"
! style="font-weight: bold;" | Disease
! style="font-weight: bold;" | Organism
! style="font-weight: bold;" | Vector
! style="font-weight: bold;" | Endemic Regions
! style="font-weight: bold;" | Symptoms
! style="font-weight: bold;" | Treatment
|-
| style="font-style: italic;" | Borreliosis (Lyme Disease)
| Borrelia burgdorferi sensu lato (bacterium)
| Deer Tick (Ixodes scapularis, I. pacificus, I. ricinus, I. persulcatus)
| North America, Europe, and Asia
| Flu-like illness, fatigue, fever, arthritis, neuroborreliosis, cranial nerve palsy, carditis and erythema migrans.
| Antibiotics (Doxycycline- if not pregnant.
or
Amoxicillin if pregnant)
|-
| style="font-style: italic;" | Relapsing Fever
| Borrelia Species; Borrelia hermsii, Borellia Parkeri, Borellia duttoni, Borrelia miyamotoi
| Ornithodoros species
| Spain, Saudi Arabia, Asia, Africa, Canada, and Western United States
| Consistently documented high fevers, flu-like illness, headaches, muscular soreness or joint pain, altered mental state, painful urination, rash, and rigors.
| Antibiotics (Doxycycline, Tetracycline, or Erythromycin**)
|-
| colspan="5" style="font-weight: bold;" | Typhus (Diseases associated with the transfer of  Rickettsia Bacteria as listed below)
|
|-
| style="font-style: italic;" | Rocky Mountain Spotted Fever
| Rickettsia Rickettsii
| Wood Tick (Dermacentor Variabilis), D. andersoni
| United States: East and Southwest
| Fever, alterations in mental state, myalgia, rash, and headaches.
| Antibiotics- Doxycycline or Tetracycline.
|-
| style="font-style: italic;" | Helvetica Spotted Fever
| Rickettsia Helvetica
| Ixodes Ricinus (European)
| Europe: Sweden, Switzerland, France and Laos
| Rash: spotted, red dots. Respiratory issues, muscle pain, and headaches.
| Antibiotics- broad-spectrum therapy and phenoxymethylpenicillin.
|-
| style="font-style: italic;" | Ehrlichiosis Anaplasmosis
| Ehrlichia Chaffeensis, E. Equi
| Lone Star Tick (Amblyomma Americanum), Ixodes Scapularis
| United States: South Atlantic and South-central
| Fever, Headache, Chills, Malaise, Muscle Pain, Nausea, Confusion, Conjunctivitis, or Rash. (60% in children and 30% in adults.)
| Antibiotics- Doxycycline, dosages should begin prior to lab results if ehrlichiosis is suspected. Adults- 100mg every 12 hours. Children (under 100lbs/45kg)- 2.2 mg/kg body weight, twice a day. 
|-
| style="font-style: italic;" | Tularemia
| Francisella Tularensis
| D. Andersoni, D. Variabilis
| United States: Found widespread throughout the region, including higher populations in the Southeast, South-central, and the West.
| Ulceroglandular, Glandular, Oculoglandular, Oroglandular, Pneumonic, Typhoidal.
| Antibiotics- Streptomycin, Gentamicin, Doxycycline, and Ciprofloxacin.
|}
Primary method of treatment**
===Viral===
{| class="wikitable"
! style="font-weight: bold;" | Disease
! style="font-weight: bold;" | Organism
! style="font-weight: bold;" | Vector
! style="font-weight: bold;" | Endemic Regions
! style="font-weight: bold;" | Symptoms
! style="font-weight: bold;" | Treatment
|-
| Tick-borne Meningoencephalitis
| TBEV virus
| style="font-style: italic;" | Ixodes Scapularis, I. Ricinus, I.persulcatus
| Europe and Northern Asia
| Early Phase: Non-specific symptoms including fever, malaise, anorexia, muscle pains, headaches, nausea, and vomiting. Second Phase: Meningitis symptoms, headache, stiff neck, encephalitis, drowsiness, sensory disturbances, and potential paralysis.
| No specific drug therapy. May require hospitalization and supportive care, including anti-inflammatory drugs, corticosteroids, or, if necessary, incubation and ventilator support. 
|-
| Colorado Tick Fever
| CTF virus
| style="font-style: italic;" | Dermacentor andersoni
| Western United States
| Common symptoms include fever, chills, headache, body aches, and lethargy. Other symptoms associated with the disease include sore throat, abdominal pain, vomiting, and a skin rash. A biphasic fever is a hallmark of Colorado Tick Fever and presents itself in nearly 50% of infected patients.
| There are no current therapies associated with Colorado Tick Fever. The majority of patients exhibiting symptoms recover completely, however severe cases require hospitalization.
|-
| Crimean-Congo Hemorrhagic Fever
| CCHF virus
| style="font-style: italic;" | Hyalomma marginatum, Rhipicephalus bursa
| South Asia, North Africa, Southern Europe
| Initially infected patients will likely feel a few of the following symptoms; headache, high fever, back and joint pain, stomach pain, vomiting, flushed face, red throat petechiae of the palate, and potentially changes in mood as well as sensory perception.
| Treatment for Crimean-Congo Hemorrhagic Fever is primarily supportive including balancing electrolytes, oxygen abnormalities, and if necessary, hemodynamic support. In vitro, Crimean-Congo Hemorrhagic Fever is responsive to an antiviral treatment with Ribavirin.
|-
| Severe Febrile Illness
| Heartland Virus
| style="font-style: italic;" | Lone Star Tick (amblyomma americanum)
| Missouri and Tennessee (United States)
|
|
|}
===Protozoan===
{| class="wikitable"
! style="font-weight: bold;" | Disease
! style="font-weight: bold;" | Organism
! style="font-weight: bold;" | Vector
! style="font-weight: bold;" | Endemic Regions
! style="font-weight: bold;" | Symptoms
! style="font-weight: bold;" | Treatment
|-
| Babesiosis
| style="font-style: italic;" | Babesia microti, B divergens, B.equi
| style="font-style: italic;" | Ixodes Scapularis, I. pacificus
| Primarily the Northeastern United States, parts of Europe and Asia.
| Non-specific flu like symptoms.
| Atovaquone combined with Azithromycin or Clindamycin combined with Quinine.
|}


==References==
==References==

Revision as of 14:48, 28 December 2015

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Overview

Babesiosis must be differentiated from other tick-borne diseases that cause fever, soreness, and rash, such as Lyme disease, Rocky Mountain Spotted fever, and Colorado tick fever.

Differentiating Babesiosis from other Diseases

Babesiosis may commonly be misdiagnosed as the following diseases:

  • Lyme disease
  • Malaria
  • Colorado tick fever
  • Anaplasmosis
  • Ehrlichiosis
  • Bartonellosis
  • Rickettsiosis
  • Taluremia
  • Q fever
  • Leptospirosis

References