Borrelia miyamotoi infection, a newly-recognized tick-borne illness, has been observed in patients thought to have human granulocytic anaplasmosis (HGA).
There are 11 recognized tick-borne illnesses in the northeastern United States and all can present as undifferentiated flu-like illness. In areas where deer ticks are common and Lyme disease, babesiosis, and HGA are prevalent, patients presenting with sudden fever, myalgia, leucopenia, and elevated aminotransferase levels are presumptively diagnosed with HGA.