Methods: A retrospective chart review was performed to establish a case series of patients with PCR positive for B. miyamotoi in an attempt to further characterize demographics, clinical presentations, co-infections, laboratory abnormalities and treatment courses for B. miyamotoi disease.
Results: 2592 patients had a bundled tick-borne illness panel sent for unexplained fever and other symptoms. 18 tested positive for B. miyamotoi PCR (0.7% positivity rate). 1 was co-infected with Babesia microti; an additional 6 had positive Lyme serology. 11 patients were prescribed doxycycline, and 1 was prescribed amoxicillin-clavulanate.
Conclusion: B. miyamotoi testing was bundled to a pre-existing tick-borne illness panel to potentially account for unexplained fevers and other symptoms in high-risk patients. Treatment recommendations for B. miyamotoi are based on case reports of successful treatments in other causes of relapsing fever, thus similar antibiotics regimens are used for both. The cost for this additional test is $25/test in our setting. Despite the endemic nature of B. miyamotoi in RI, the utility of Borrelia PCR in first-line screening for patients with unexplained fever may be minimal from a cost-benefit perspective.
R. Reece, None
T. Flanigan, None
F. Silverblatt, None
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