Hematologic Complications of Tick Bites and Tick-Borne Illness: A Brief Narrative Review

Main Article Content

Zain El-amir, MD Amar Ghaleb Shobha Mandal, MD Paritharsh Ghantasala, MD FACP Asim Kichloo, MD

Abstract

Introduction: Tick-borne illnesses are rising in the United States, and tick bites can result in hematologic complications including anemia, thrombocytopenia, pancytopenia, and even life-threatening sequelae like disseminated intravascular coagulation. While case reports and brief reviews exist for specific ticks, there is a lack of review on the known hematologic complications after various tick-borne illnesses.


Methodology: This narrative review examined over twenty articles on hematologic complications of tick-borne illnesses published from 2000 onwards. A comprehensive search of electronic databases, including PubMed and Google Scholar, was conducted to identify relevant literature published between 2000 and 2024. Inclusion criteria comprised articles available in English and those describing hematologic consequences of tick-borne illnesses. Exclusion criteria included duplicates, unpublished works, and studies not directly related to the topic. A total of over twenty articles were screened based on title and abstract for eligibility.


Discussion: Tick bites can cause various hematologic complications, including anemia, leukopenia, thrombocytopenia, pancytopenia, and disseminated intravascular coagulation by various mechanisms. While it can cause marrow suppression, tick bites can also cause leukocytosis. Clinically, patients can present with profuse bleeding or bruising in some cases or severe diseases like disseminated intravascular coagulation. Workup for these various hematologic pathologies can include complete blood counts and peripheral blood smears.


Conclusions: Early identification of hematologic abnormalities related to tick-borne illnesses can be important for clinical management.

Article Details

How to Cite
EL-AMIR, Zain et al. Hematologic Complications of Tick Bites and Tick-Borne Illness: A Brief Narrative Review. Medical Research Archives, [S.l.], v. 12, n. 7, july 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5489>. Date accessed: 21 dec. 2024. doi: https://doi.org/10.18103/mra.v12i7.5489.
Section
Review Articles

References

1. Pace EJ, O’Reilly M. Tickborne Diseases: Diagnosis and Management. Am Fam Physician. 2020;101(9):530-540. Accessed December 5, 2023.
2. Goodman A, Bilal M, Amarnath S, Gentile T, Shepherd Z. The unusual case of babesiosis causing disseminated intravascular coagulation with hemophagocytic lymphohistiocytosis. Clin Case Rep. 2021;9(9).
3. Pantanowitz L. Mechanisms of Thrombocytopenia in Tick-Borne Diseases. The Internet Journal of Infectious Diseases. 2002;2(2).
4. Biggs HM, Behravesh CB, Bradley KK, et al. Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States. MMWR Recomm Rep. 2016;65(2):1-44.
5. Jensenius M, Fournier PE, Hellum KB, et al. Sequential changes in hematologic and biochemical parameters in African tick bite fever. Clinical Microbiology and Infection. 2003;9(7):678-683.
6. Fuchs I, Tarabin S, Kafka M. Relapsing Fever: Diagnosis Thanks to a Vigilant Hematology Laboratory. 2015;15(7):446-448.
7. Madison-Antenucci S, Kramer LD, Gebhardt LL, Kauffman E. Emerging tick-borne diseases. Clin Microbiol Rev. 2020;33(2).
8. Akel T, Mobarakai N. Hematologic manifestations of babesiosis. Ann Clin Microbiol Antimicrob. 2017;16(1):1-7. doi:10.1186/S12941-017-0179-Z/TABLES/3
9. Silva-Ramos CR, Faccini-Martínez ÁA. Clinical, epidemiological, and laboratory features of Rickettsia africae infection, African tick-bite fever: A systematic review. Infez Med. 2021;29(3):366.
10. Paddock CD, Childs JE. Ehrlichia chaffeensis: A prototypical emerging pathogen. Clin Microbiol Rev. 2003;16(1):37-64.
11. Edginton S, Guan TH, Evans G, Srivastava S. Human granulocytic anaplasmosis acquired from a blacklegged tick in Ontario. CMAJ. 2018;190(12):E363-E366.
12. Wang F, Wu Y, Jiao J, Wang J, Ge Z. Risk factors and clinical characteristics of severe fever with thrombocytopenia syndrome. Int J Gen Med. 2020;13:1661-1667.
13. Liu Q, He B, Huang SY, Wei F, Zhu XQ. Severe fever with thrombocytopenia syndrome, an emerging tick-borne zoonosis. Lancet Infect Dis. 2014;14(8):763-772.
14. Monette DL, Miller ES, Zachary KC, Wittels K, Wilcox SR. Abdominal Pain After a Tick Bite. Journal of Emergency Medicine. 2019;57(4):563-566.
15. Baldeo C, Seegobin K, Zuberi L. Immune Thrombocytopenia as a Consequence of Rocky Mountain Spotted Fever. Case Rep Oncol. 2018;10(3):945-947.
16. Said M. Tick Borne Disease Induced Pancytopenia. Infectious Diseases and Clinical Microbiology. 2021;3(1):35-38.
17. Varshney A, Barkoudah E. The Simplest Explanation: Pancytopenia. American Journal of Medicine. 2018;131(9):1052-1054.
18. Human granulocytic anaplasmosis. Accessed January 1, 2024. https://imagebank.hematology.org/image/15241/human-granulocytic-anaplasmosis
19. Papa A, Maltezou HC, Tsiodras S, et al. A case of Crimean-Congo haemorrhagic fever in Greece, June 2008. Euro Surveill. 2008;13(33):18952.
20. Disseminated intravascular coagulation: a complication of Babesia canis infection in the dog - PubMed. Accessed January 1, 2024. https://pubmed.ncbi.nlm.nih.gov/553964/
21. Choi E, Pyzocha N, Maurer D. Tick-borne illnesses. Current Sports Medicine Reports. 2016;15(2):98-104.
22. Diza JH. Ticks, including tick paralysis. Mandell, Douglass, and Bennett’s Principles and Practice of Infectious Diseases. 2015;3266-3279.e1.
23. McGain F, Welton R, Solley GO, et al. First fatalities from tick bite anaphylaxis. Journal of Allergy and Clinical Immunology: In Practice. 2016;4(4):769-770.
24. Monette DL, Miller ES, Zachary KC, et al. Abdominal pain after a tick bite. Journal of Emergency Medicine. 2019;57(4):563-566.
25. Boulanger N, Boyer P, Talagrand-Reboul E, et al. Ticks and tick-borne diseases. Medicine et Maladies Infectiuses. 2019;49(2):87-97.