Table 1.

Headache is a common feature of many TBDs. It often presents with other neurological symptoms. Case reports and scholarly literature indicate headache occurs in LD, Borrelia miyamotoi disease (BMD), and Powasan Virus, among others.

Occurs in early stages of LD. Common with other symptoms, such as fever, myalgia (muscle pain), arthralgia (joint stiffness), fatigue, flu-like symptoms, cranial nerve palsies, neck-stiffness, and meningitis. A headache is one of the most common manifestations of LD.	[6,12,36,37]
RMSF can cause a severe headache that is typically accompanied by a host of symptoms, including, nausea, vomiting, extreme fatigue, fever, and pain.	[7]
Meningitis, and associated headaches, is a neurologic expression of early-disseminated LD.	[7,38,39]
A headache is a clinical presentation in the co-infection, babesiosis, which is a parasite transmitted by the same tick that transmits LD. Babesiosis causes a malaria-like illness.	[40]
Headaches are common among patients infected with Bartonella species, specifically B. henselae. Headaches are reported with additional neurological symptoms, including memory loss, numbness, or a loss of sensation and balance problems.	[41,42]
Borrelia miyamotoi disease (BMD) symptoms include the following: fever, chills, headache, myalgia, arthralgia, malaise, and fatigue. Presentation of BMD is similar to human anaplasmosis and a differential diagnosis is warranted.	[12,43]
In human ehrlichiosis, headaches presents with fever, malaise, myalgia, and numerous multisystem presentations. Meningoencephalitis occurs in 20% of patients.	[44,45]
A headache is a clinical feature of tularemia.	[46]
Eighty-two percent of patients with anaplasmosis reported a headache.	[47]
A case report of a man in his sixties with a headache and non-focal weakness showed Powassan virus disease (PVD) in a serum analysis.	[48]
Headaches are reported by the CDC in the following TBDs: Lyme disease, babesiosis, Borrelia miyamotoi disease (severe headache), Heartland virus, anaplasmosis, Bourbon virus disease, Rocky Mountain spotted fever (severe headache), PVD, rickettsiosis, Tick-borne relapsing fever, tularemia, Colorado tick fever, Rickettsia parkeri rickettsiosis, and ehrlichiosis.	[27]