Ehrlichiosis

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Background

  • Bacterial infection of the family Anaplasmataceae common in mammals such as cattle, dogs, sheep, goats, and horsesCite error: Closing </ref> missing for <ref> tag
    • More severe disease in immunocompromised patients (HIV, Elderly, Asplenic)

Symptoms

  • Fever, chills, headache, malaise, myalgias, nausea, vomiting, diarrhea, conjunctival injection
    • Up to 60% of children may have a rash (30% of adults)

Diagnosis

  • Peripheral blood smear[1]
  • Obligate intracellular organism
    • Smear shows intracellular parasites only 20% of time
  • PCR
    • Most sensitive in first week of illness
  • Indirect Immunoflorescence Assay'
    • Gold Standard
    • Negative 85% of time in first 7 days of illness
    • Compare 2 samples drawn at different times
    • 4 fold increase in titers of second draw is positive
  • Enzyme Immunoassay
    • Qualitative tests, not quantitative
  • Leukopenia, elevated transaminases, thrombocytopenia often present

Treatment

  • Doxycycline
    • 100mg BID (Adults)
    • 2.2mg/kg BID (children)

See also

Tick Borne Illnesses

Sources