Removal · field guidance

Diagnosing Lyme + Anaplasma + Babesia co-infection

All three can be transmitted by Ixodes scapularis in a single bite; testing strategy combines serology, PCR, and blood smear.

Steps

schema.org/HowTo

01
Lyme: order standard two-tier or modified two-tier serology.
02
Anaplasma: order whole-blood PCR (acute) plus paired IFA (convalescent).
03
Babesia: order Giemsa thin/thick smear and B. microti PCR.
04
CBC clues — leukopenia and thrombocytopenia raise suspicion for anaplasmosis or babesiosis even when Lyme is the obvious diagnosis.
05
Treat empirically while results pend if the patient is severely ill — doxycycline covers Lyme and Anaplasma but not Babesia.

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