Borrelia miyamotoi

Background

• Tick-borne infection
• Transmitted by hard-body ticks, including Ixodes scapularis (in northeastern and nortcentral North America), Ixodes pacificus (in northwestern North America), Ixodes ricinus (in Europe), Ixodes persulcatus (in Europe and Asia), and Ixodes ovatus, Ixodes nipponensis, and Ixodes pavoloskyi (in Asia)
• Present worldwide, including Canada

Clinical Manifestations

• In immunocompetent patients, often causes a self-limited flu-like illness
• Can have relapses, similar to tick-borne relapsing fever
• Disease more severe in immunocompromised patients, including meningoencephalitis

Management

• Doxycycline if no neurologic involvement
• Ceftriaxone if neurologic involvement
• Also azithromycin
• Resistant to amoxicillin

Further Reading

• Borrelia miyamotoi: A Comprehensive Review. Pathogens. 2023 Feb 7;12(2):267. doi: 10.3390/pathogens12020267. PMID: 36839539; PMCID: PMC9967256.
• Human Borrelia miyamotoi Infection in North America. Pathogens. 2023 Apr 3;12(4):553. doi: 10.3390/pathogens12040553. PMID: 37111439; PMCID: PMC10145171.