Conclusion Borrelia miyamoto, a spirochete that is discovered in Japan in 1995, belongs to the relapsing fever group of borrelia It was first identified as a human pathogen in 2011, which is now recognized as the fifth agent of human disease to be transmitted by the ixodes scapularis(肩突硬蜱) tick in the northeastern United states Diagnoses: Exposure: outdoor activities or contact with pets and mice cErtain features: including headache rash, thrombocytopenia, and hepatitis ◆ Laboratory data Blood RT: the platelet decreased earlier and neutrophils Lymphocytes changed Real-time PCr testing: targeting the 23S ribosomal rna gene of borrelia species was positiv ELISA: initially negative for igM and lgg antibodies to the glpQ antigen of B. miyamoto. 1 week later, ELISA was positive for the igM antibodies but negative for the IgG antibodies findings that are consistent with recent b. miyamoto infectionBorrelia miyamotoi, a spirochete that is discovered in Japan in 1995, belongs to the relapsing fever group of Borrelia .It was first iden9fied as a human pathogen in 2011, which is now recognized as the fiSh agent of human disease to be transmiTed by the Ixodes scapularis （肩突硬蜱）9ck in the northeastern United States. Diagnoses: uExposure: outdoor ac9vi9es or contact with pets and mice uCertain features: including headache, rash, thrombocytopenia, and hepa99s uLaboratory Data Blood RT: the platelet decreased earlier and neutrophils 、Lymphocytes changed Real-9me PCR tes9ng: targe9ng the 23S ribosomal RNA gene of borrelia species was posi9ve ELISA: ini9ally nega9ve for IgM and IgG an9bodies to the glpQ an9gen of B.miyamotoi. 1 week later, ELISA was posi9ve for the IgM an9bodies but nega9ve for the IgG an9bodies, findings that are consistent with recent B. miyamotoi infec9on. Conclusion