A clinician should suspect that patients with Lyme disease also have Babesiosis (if they have hemolytic anemia and thrombocytopenia) Human granulocytic anaplasmosis (if they have elevated aminotransferase levels, leukopenia, inclusion bodies in neutrophils, and / or thrombocytopenia) Acute rheumatic fever is considered in the occasional patient with migratory polyarthralgias and either an increased PR interval or chorea (as a manifestation of meningoencephalitis).