title: Tickborne infections as a cause of nonspecific febrile illness in Wisconsin.
abstract: Lyme disease, human granulocytic ehrlichiosis (HGE), and babesiosis are tickborne infections that are indigenous to Wisconsin. To assess their importance as a cause of nonspecific fever, we recruited patients with febrile illness at 10 clinics in northwestern Wisconsin from May through August of both 1997 and 1998. Eligible patients had a temperature >38.0 degrees C but no rash or other localizing source. Acute and convalescent serological tests were performed for Borrelia burgdorferi, Babesia microti, and Ehrlichia equi; polymerase chain reaction was performed to detect granulocytic Ehrlichia rDNA. Seventeen (27%) of 62 eligible patients had laboratory evidence of tickborne infection, including 7 (11%) with probable Lyme disease only, 8 (13%) with HGE only, and 2 (3%) with apparent coinfection. No patients with Babesia infection were identified. Patients with and without tickborne infection were similar with regard to age, sex, symptoms, history of tick bite, and outdoor exposure. The results suggest that tickborne infections are an important cause of nonspecific febrile illness during the tick season in northwestern Wisconsin.
authors.affiliation: Epidemiology Research Center, Marshfield Medical Research Foundation and Marshfield Clinic, Marshfield, WI 54449, USA. belongie@mfldclin.edu
authors.forename: E A
authors.initials: EA
authors.lastname: Belongia
authors.forename: K D
authors.initials: KD
authors.lastname: Reed
authors.forename: P D
authors.initials: PD
authors.lastname: Mitchell
authors.forename: N
authors.initials: N
authors.lastname: Mueller-Rizner
authors.forename: M
authors.initials: M
authors.lastname: Vandermause
authors.forename: M F
authors.initials: MF
authors.lastname: Finkel
authors.forename: J J
authors.initials: JJ
authors.lastname: Kazmierczak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D001898:Borrelia / Q000276:immunology; D001899:Borrelia Infections / Q000175:diagnosis* / Q000503:physiopathology; D015748:Borrelia burgdorferi Group / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004536:Ehrlichia / Q000276:immunology; D016873:Ehrlichiosis / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017282:Tick-Borne Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology; D014922:Wisconsin
chemical_list: D000907:Antibodies, Bacterial