Co-Infections Jeopardy

Anaplasmosis

100

How is Anaplasmosis Transmitted?

Through the bite of a tick

200

What kind of ticks is anaplasmosis transmitted through?

The deer tick and the black legged tick

300

Can you name one of the symptoms?

Headaches, fever, muscle pains, chills, confusion, and renal failure

400

When do most cases of anaplasmosis occur?

In the spring and summer months

500

Where do most cases of anaplasmosis occur?

In New England and North Central United States

Ehrlichiosis

100

How is Ehrlichiosis transmitted? (What kind of tick?)

Though the bite of a Lone Star Tick

200

What are some symptoms of Ehrliciosis?

Headaches, Fatigue, Muscle aches, and sometimes nausea, diarrhea, cough, joint pains, confusion, and occasionally rashes

300

What are some long-term complications of Ehrlichiosis?

Long-term Complications o Kidney failure o Respiratory failure o Heart failure o Seizures o Coma

400

Can you name one of the risk factors to get ehrlichiosis?

•Being outdoors in warm weather. Most cases of ehrlichiosis occur in the spring and summer months when populations of the Lone Star tick are at their peak and people are outside for activities such as hiking, golfing, gardening and camping. •Living in or visiting an area with a high tick population. You are at greater risk if you are in an area with a high Lone Star tick population. •Being male. Ehrlichiosis infections are more common in males, likely because of increased time outdoors for work and recreation.

500

What is the treatment of ehrlichiosis?

Tetracycline antibiotic

Babesiosis

100

What is babesiosis?

Babesiosis is caused by microscopic parasites that infect red blood cells and are spread by certain ticks.

200

How can people get infected with Babesiosis?

People can get infected with Babesia parasites in several ways: •The main way is through the bite of an infected tick—during outdoor activities in areas where babesiosis is found. •A less common way of becoming infected is by getting a transfusion from a blood donor who has a silent Babesia infection. (No tests have been licensed yet for screening blood donations for Babesia.) •A few possible cases of congenital transmission—from an infected mother to her baby (during pregnancy or delivery)—have been reported.

300

What geographical region do most people get infected with babesiosis?

Tickborne transmission primarily occurs in the Northeast and upper Midwest, especially in parts of New England, New York State, New Jersey, Wisconsin, and Minnesota.

400

What are the some of the symptoms of Babesiosis?

Some people develop nonspecific flu-like symptoms, such as fever, chills, sweats, headache, body aches, loss of appetite, nausea, or fatigue. Complications of babesiosis can include: • a low and unstable blood pressure; • severe hemolytic anemia (hemolysis); • a very low platelet count (thrombocytopenia); • disseminated intravascular coagulation (also known as “DIC” or consumptive coagulopathy), which can lead to blood clots and bleeding; • malfunction of vital organs (such as the kidneys, liver, lungs, and heart); or •death

500

What is one of the treatments for Babesiosis?

In general, babesiosis usually is treated for at least 7-10 days with a combination of two prescription medications – typically either: •atovaquone PLUS azithromycin; OR •clindamycin PLUS quinine (this combination is the standard of care for severely ill patients). Some patients—including those with severe illness—might require or benefit from supportive care, such as: •antipyretics (to decrease fever); •vasopressors (to increase the blood pressure, if it is low and unstable); •blood transfusions; •exchange transfusions (in which portions of a patient’s blood or blood cells are replaced with transfused blood products); •mechanical ventilation (if patients have trouble breathing on their own); or •dialysis (if their kidneys stop working normally).

Bartonella

100

What is Bartonella?

Bartonella is an intracellular, gram-negative bacteria that can become chronic.

200

Is Bartonella always seen in patients?

No, Bartonella may not present in its usual form when additional infections, such as Lyme or Babesia are present. In addition, typical Bartonella lesions are not always seen in patients, therefore, a diagnosis of "fever of unknown origin" should alert a physician to consider Bartonella. It is estimated that approximately 2/3 of the patients with Bartonella have a fever. Involvement of practically every organ has been reported.

300

What are the symptoms associated with Bartonella?

Fatigue, Restlessness, Combative behavior, Myalgias, Malaise, Liver and/or Spleen involvement, Abdominal pain, Infectious Mononucleosis-like Syndrome, Granulomatous Hepatitis

400

What are the targeted body organs of Bartonella?

Brain Rash and Lympadenitis Eyes Bones and Muscles Heart

500

What is the treatment?

You MUST consult a knowledgeable physician for information on treatment for disseminated Bartonella. Some of the medications which have been used in the past have included Doxycycline (with or without Rifampin), Ciprofloxacin, Erythromycin, Azithromycin, trimethoprim-sulphamethoxazole, gentamicin, and other macrolide antibiotics.