The Internet Book of Critical Care Podcast IBCC Episode 39 - TickBorne Illness
Jun 6, 2019
Explore the urgent world of tick-borne illnesses affecting ICU patients. Dive into the differences between babesiosis, anaplasmosis, and RMSF, and learn about their unique clinical implications. Discover how changing climates impact tick distributions and disease occurrences. The hosts dissect symptoms, from flu-like presentations to severe complications like ARDS and multiorgan failure. They also tackle diagnostics and treatment strategies, emphasizing the vital role of early intervention and the challenges of co-infections.
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Start Doxycycline Early
- If you suspect tick-borne rickettsial infections, start doxycycline immediately rather than waiting for confirmatory tests.
- Doxy covers anaplasmosis, ehrlichiosis, and RMSF but not babesiosis, so evaluate for babesiosis separately.
Cell Tropism Explains Disease Patterns
- Different tick pathogens target different cell types which explains clinical differences.
- Babesia infects erythrocytes, anaplasma/ehrlichia infect leukocytes, and RMSF targets endothelium.
Ask Exposure History Broadly
- Do not rely on a remembered tick bite to exclude disease; about half of patients don't recall a bite.
- Ask about rural/suburban exposure, travel, and sick pets or coworkers to raise suspicion.