Tick vector: Ixodes scapularis, other Ixodes species
The patient may be immunocompromised.
Clinical findings:
(1) fever which may become relapsing
(2) influenza-like findings (headache, myalgia, chills)
(3) meningoencephalitis
(4) variable erythema migrans skin lesion
Defintive diagnosis may require:
(1) direct demonstration of the organism (of limited use clinically)
(2) serologic changes (IgM, rise in titer)
(3) PCR or other molecular technique
Often the diagnosis is not considered until other causes such as Lyme disease or STARI have been excluded.
