All right, welcome back to the Internet Book of Critical Care Podcast.

I'm here with Adam Thomas and we're going to talk about tick-borne illnesses presenting to the

intensive care unit.

As we were joking, Josh, how would you emphasize the preparation went for this?

Would it be a magical walk in the park or a dumpster fire?

This is a really difficult topic because after reading a lot about this and thinking about it,

I'm still mystified as to how I'm going to actually diagnose these patients walking into the ICU.

Like everything else we do, damn near luck. Exactly.

Everyone gets doxycline and you pray to God it's not babiosis. Yeah, that's the

bottom line. In spring, summertime, just doxy for everyone. Back in med school, you remember

tick-borne illnesses, they're bacterial, including spiroketal. I don't know, Josh, how do you

guys say it on the East Coast? I don't know. I'll go with it. We got some rickettsials, we got some parasitic or protozole and viral. We're today going to talk about

some of the spirochetyl, spirochetyl, some of the rickettsial, and one of the protozole. So Josh,

walk me through the rationale for the reverse white walkers that is this chapter. Everything marching north to us

Canadians. You Americans are invading us with your exoities ticks. What's going on here?

So seriously, we didn't used to see much of this in Vermont, but with changes in the climate

and the duration of the winter and stuff, we've actually seen a substantial increase in

anaplasmosis here. And unfortunately, if we continue to have global warming and stuff like that,

there may be substantial shifts in the tick distribution.

So it's possible that America ticks are going to invade Canada and re-cavick.

So many Trump jokes to make so many Trump jokes.

The illnesses here are difficult to diagnose,

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