Differential Diagnosis for Infectious Etiologies Specific to Maryland

Single Most Likely Diagnosis

• Lyme Disease: Justification - Maryland is located in a region with a high incidence of Lyme disease, which is transmitted by the blacklegged tick. The state's climate and geography create an ideal environment for ticks, making Lyme disease a common concern.

Other Likely Diagnoses

• Rocky Mountain Spotted Fever (RMSF): Justification - Although not as prevalent as Lyme disease, RMSF is another tick-borne illness found in Maryland. Its symptoms can be severe, and early diagnosis is crucial.
• Babesiosis: Justification - This parasitic disease is also transmitted by ticks and can be found in Maryland. It's particularly concerning for individuals with weakened immune systems.
• Ehrlichiosis/Anaplasmosis: Justification - These bacterial infections are transmitted by ticks as well and have been reported in Maryland. They can cause significant illness if not treated promptly.

Do Not Miss Diagnoses

• Rabies: Justification - While not exclusively a Maryland issue, rabies is present in the state and can be transmitted through animal bites. It's almost always fatal if not treated immediately after exposure.
• Eastern Equine Encephalitis (EEE): Justification - This viral disease is transmitted by mosquitoes and can be deadly. Maryland has reported cases, and due to its severity, it should not be missed.

Rare Diagnoses

• Powassan Virus Disease: Justification - This is a rare but potentially serious tick-borne disease. While cases are not common in Maryland, the state's tick population could potentially carry the virus.
• La Crosse Encephalitis: Justification - Transmitted by mosquitoes, this viral disease is more commonly associated with the Midwest but can be found in Maryland. It's rare but can cause severe neurological symptoms.