James Gwinn
BIOL 840 Infectious Disease - Fall 16
Case Study
Scenario:
Earlier this week, a middle-aged man came into an urgent care facility referencing a high fever and severe chills for a couple days. He has also been experiencing muscle aches, headache, and an overall tiredness. He has not been feeling well for the past two weeks. Since the patient revealed that he did not receive a seasonal flu-shot, he was prescribed Theraflu and sent home. After a couple more days, the patient returned to the office with no improvement with additional nausea and vomiting. The doctor prescribed a simple blood test and noticed that the man was suffering from hemolytic anemia.
The man is from New Hampshire and spends most of his time outdoors. He enjoys hunting, fishing, and trail-hiking. He has …show more content…
What tests should be run to identify his infection? What is the main distinguishing character of this parasite in a blood smear?
3. What treatment would you provide this man?
4. Why is it common for this disease to be confused with other parasitic diseases?

Answers:
1. Differential Diagnosis –
a. Lyme Disease - Borrelia burgdorferi
i. Transmitted by infected blacklegged ticks ii. Common in areas of the Northeastern United States iii. Symptoms include:
1. Fever, headache, fatigue
2. Erythema migrans rash (red bullseye) iv. Tested for using ELISA for B. burgorferi antibodies if no “bullseye” rash is present
b. Malaria - Plasmodium spp.
i. Transmitted through mosquitoes ii. Largely eradicated in the United States
1. Most commonly found in international travelers iii. Symptoms include:
1. High fever, chills, headache, nausea, vomiting
2. Enlarged liver, mild jaundice, enlarged spleen
3. Anemia caused by the destruction of red blood cells iv. Diagnosed through the detection of parasites in the blood
c. Babesiosis- Babesia microti
i. Parasitic disease spread through blacklegged ticks ii. Most commonly occurs in the upper Midwest and particularly in parts of New England and New York