Lyme disease differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Lyme disease must be differentiated from babesiosis, leptospirosis, mononucleosis, viral meningitis, and chronic diseases such as SLE, fibromyalgia, and chronic fatigue syndrome.
Differentiating Lyme disease from other tick-borne diseases
Lyme disease must be differentiated from other diseases that may cause arthralgia, fever, and skin manifestations and that are associated with a history of tick exposure.
| Disease | Organism | Vector | Symptoms | |
|---|---|---|---|---|
| Bacterial Infection | ||||
| Borreliosis (Lyme Disease) [1] | Borrelia burgdorferi sensu lato complex and B. mayonii | I. scapularis, I. pacificus, I. ricinus, and I. persulcatus | Erythema migrans, flu-like illness(fatigue, fever), arthritis, neuroborreliosis, cranial nerve palsy, and carditis. | |
| Relapsing Fever [2] | Tick-borne relapsing fever (TBRF): | Borrelia duttoni, Borrelia hermsii, and Borrelia parkerii | Ornithodoros species | Consistently documented high fevers, flu-like illness, headaches, muscular soreness or joint pain, altered mental status, painful urination, rash, and rigors. |
| Louse-borne relapsing fever (LBRF) : | Borrelia recurrentis | Pediculus humanus | ||
| Typhus (Rickettsia) | ||||
| Rocky Mountain Spotted Fever | Rickettsia Rickettsii | Dermacentor Variabilis, D. andersoni | Fever, altered mental status, myalgia, rash, and headaches. | |
| Helvetica Spotted Fever [3] | Rickettsia Helvetica | Ixodes Ricinus (European) | Rash: spotted, red dots. Respiratory symptoms (dyspnea, cough), muscle pain, and headaches. | |
| Ehrlichiosis Anaplasmosis [4] | Ehrlichia Chaffeensis, E. Equi | Lone Star Tick (Amblyomma Americanum), Ixodes Scapularis | Fever, headache, chills, malaise, muscle pain, nausea, confusion, conjunctivitis, or rash (60% in children and 30% in adults). | |
| Tularemia [5] | Francisella Tularensis | D. Andersoni, D. Variabilis | Ulceroglandular, glandular, oculoglandular, oroglandular, pneumonic, typhoidal. | |
| Viral Infection | ||||
| Tick-borne meningoencephalitis [6] | TBEV virus | Ixodes scapularis, I. ricinus, I. persulcatus | 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. | |
| Colorado Tick Fever [7] | CTF virus | Dermacentor andersoni | 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 in nearly 50% of infected patients. | |
| Crimean-Congo Hemorrhagic Fever | CCHF virus | Hyalomma marginatum, Rhipicephalus bursa | 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. | |
| Protozoan Infection | ||||
| Babesiosis [8] | Babesia microti, B divergens, B.equi | Ixodes scapularis'', I. pacificus | Non-specific flu-like symptoms. | |
Differentiating Lyme disease from other diseases
- Allergic reaction to the tick
- Babesiosis
- Chronic fatigue syndrome (CFS)
- Depression
- Fibromyalgia
- Human granulocytic anaplasmosis (HGA)
- Leptospirosis
- Mononucleosis
- Other insect bites
- Reiter's syndrome
- Rheumatoid arthritis
- Scleroderma
- Systemic lupus erythematosus (SLE)
- Tick-borne diseases
- Viral meningitis[9]
References
- ↑ Lyme Disease Information for HealthCare Professionals. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/lyme/healthcare/index.html Accessed on December 30, 2015
- ↑ Relapsing Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015
- ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015
- ↑ Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015
- ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015
- ↑ General Disease Information (TBE). Centers for Disease Control and Prevention (2015). http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015
- ↑ General Tick Deisease Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015
- ↑ Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.
- ↑ "Lyme Disease Diseases With Similar Symptoms - Lyme Disease Health Information - NY Times Health". Retrieved 2013-03-14.