• A 50 yo male presents with severe fatigue, tactile temps, chills, fatigue, and dizziness for one week. The family also notes yellowing of his skin.  T is 102.3 oral. His labs demonstrate a Hgb of 8.8, platelets of 141, and TBili of 1.6 with a normal direct bili. Cr is noted to be elevated at 1.42 with a normal baseline. What is going on with this patient and whom should we call?

Summer is fast approaching (woohoo)! For many of us living in endemic areas, that means we need to consider tick borne illnesses in many of our differentials of patients with flu-like illnesses and possibly a rash. Lyme disease and Rocky Mountain Spotted Fever are often the diseases that we remember easily. Below are some pearls to help clinch the diagnosis of some of the lesser known tick borne illnesses or, in some cases, answer a test question correctly!