Ehrlichiosis natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Ehrlichiosis}} | {{Ehrlichiosis}} | ||
{{CMG}} {{AE}} {{IMD}} | |||
==Overview== | ==Overview== | ||
Early symptoms that are commonly associated with human granulocytotropic anaplasmosis (HGA) include sudden onset of fever and intense pains. Progression of the disease may lead to serious complications including [[neurological disorders]] and [[Acute respiratory distress syndrome|ARDS.]] Co-infection remains the greatest threat associated with death as a result of HGA. Human monocytotropic ehrlichiosis (HME) presents a very different scenario than that of HGA. HME is far more dangerous as well as deadly. An [[Incubation period|incubation]] period of 7-10 days will often follow an infected tick bite. Initial symptoms include fever, headache, and malaise. Further complications will follow the onset of infection, these complications may prove to be extremely dangerous and should be closely monitored for the patients safety. Unlike HME, the prognosis is usually good for human granulocytotropic anaplasmosis (HGA). Individuals suffering from HGA should fully recover without treatment in 2 months. However, proper treatment of HGA will expedite the recovery process. | |||
==Natural History== | ==Natural History== | ||
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===Human granulocytotropic anaplasmosis=== | ===Human granulocytotropic anaplasmosis=== | ||
====Early Stage==== | ====Early Stage==== | ||
*Sudden onset of fever with rigors | *Sudden onset of fever with [[rigors]] | ||
*Severe Myalgia | *Severe [[Myalgia]] | ||
*Early Symptoms such as pain, nausea, vomiting, weight loss, cough, and confusion | *Early Symptoms such as pain, nausea, vomiting, weight loss, cough, and confusion | ||
====Late Stage==== | ====Late Stage==== | ||
*Toxic-like Syndrome | *Toxic-like Syndrome | ||
*ARDS | *[[Acute respiratory distress syndrome|ARDS]] | ||
*Neurological disorders | *[[Neurological disorders]] | ||
*Liver complications | *Liver complications | ||
| Line 25: | Line 26: | ||
*Immuno-compromised individuals may suffer severe infections or even death as a result of an opportunistic co-infection. | *Immuno-compromised individuals may suffer severe infections or even death as a result of an opportunistic co-infection. | ||
===Human monocytotropic ehrlichiosis=== | |||
====Early Stage==== | ====Early Stage==== | ||
*Incubation of 7-10 days | *Incubation of 7-10 days | ||
*Initial presenting symptoms include fever, headache, and malaise. | *Initial presenting symptoms include fever, headache, and [[Malaise|malaise.]] | ||
*More severe infections will include myalgia, diaphoresis, weight loss, maculopapular rash, and confusion. | *More severe infections will include myalgia, [[diaphoresis]], weight loss, [[maculopapular rash]], and confusion. | ||
====Late Stage==== | ====Late Stage==== | ||
| Line 38: | Line 40: | ||
====If left untreated==== | ====If left untreated==== | ||
*HME remains a life-threatening disease | *HME remains a life-threatening disease | ||
*Without proper treatment patients may suffer from hypotension, respiratory failure, acute renal failure, and hemorrhagic manifestations | *Without proper treatment patients may suffer from [[hypotension]], [[respiratory failure]], [[Acute renal failure (patient information)|acute renal failure]], and hemorrhagic manifestations | ||
*Death | *Death | ||
==Complications== | ==Complications== | ||
Common complications associated with an ehrlichiosis infection are listed below: | |||
* [[Acute respiratory distress syndrome|Respiratory distress syndrome]] | * [[Acute respiratory distress syndrome|Respiratory distress syndrome]] | ||
* [[Hepatitis]] | * [[Hepatitis]] | ||
* [[Seizure]] | * [[Seizure]] | ||
* [[Candidiasis]] | * [[Candidiasis]] | ||
| Line 53: | Line 53: | ||
==Prognosis== | ==Prognosis== | ||
=== | ===Human granulocytotropic anaplasmosis=== | ||
*The prognosis for HGE is usually good. | *The prognosis for HGE is usually good. | ||
*With proper treatment, patients should fully clear infection | *With proper treatment, patients should fully clear infection | ||
| Line 60: | Line 60: | ||
*Death associated with opportunistic co-infection. | *Death associated with opportunistic co-infection. | ||
=== | ===Human monocytotropic ehrlichiosis=== | ||
*HME is a severe illness with many complications | *HME is a severe illness with many complications | ||
*Even in the presence of proper medical therapy, nearly 2.7% of infected patients will die | *Even in the presence of proper medical therapy, nearly 2.7% of infected patients will die | ||
| Line 69: | Line 69: | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Latest revision as of 17:38, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.
Overview
Early symptoms that are commonly associated with human granulocytotropic anaplasmosis (HGA) include sudden onset of fever and intense pains. Progression of the disease may lead to serious complications including neurological disorders and ARDS. Co-infection remains the greatest threat associated with death as a result of HGA. Human monocytotropic ehrlichiosis (HME) presents a very different scenario than that of HGA. HME is far more dangerous as well as deadly. An incubation period of 7-10 days will often follow an infected tick bite. Initial symptoms include fever, headache, and malaise. Further complications will follow the onset of infection, these complications may prove to be extremely dangerous and should be closely monitored for the patients safety. Unlike HME, the prognosis is usually good for human granulocytotropic anaplasmosis (HGA). Individuals suffering from HGA should fully recover without treatment in 2 months. However, proper treatment of HGA will expedite the recovery process.
Natural History
Infection varies according to the Ehrlichiae agent responsible for the infection. Listed below are the progressive pathways of each infection:
Human granulocytotropic anaplasmosis
Early Stage
- Sudden onset of fever with rigors
- Severe Myalgia
- Early Symptoms such as pain, nausea, vomiting, weight loss, cough, and confusion
Late Stage
- Toxic-like Syndrome
- ARDS
- Neurological disorders
- Liver complications
If left untreated
- Usually achieve a full recovery in 2 months
- Immuno-compromised individuals may suffer severe infections or even death as a result of an opportunistic co-infection.
Human monocytotropic ehrlichiosis
Early Stage
- Incubation of 7-10 days
- Initial presenting symptoms include fever, headache, and malaise.
- More severe infections will include myalgia, diaphoresis, weight loss, maculopapular rash, and confusion.
Late Stage
- Progression of symptoms requires hospitalization
- Majority of infected patients require intensive care
- Even with medical therapy 2.7% of infected patients die
If left untreated
- HME remains a life-threatening disease
- Without proper treatment patients may suffer from hypotension, respiratory failure, acute renal failure, and hemorrhagic manifestations
- Death
Complications
Common complications associated with an ehrlichiosis infection are listed below:
- Respiratory distress syndrome
- Hepatitis
- Seizure
- Candidiasis
- Opportunistic nosocomial infections[1]
- Death
Prognosis
Human granulocytotropic anaplasmosis
- The prognosis for HGE is usually good.
- With proper treatment, patients should fully clear infection
- About Half of infected individuals will require 6 days of hospitalization
- Even in the absence of treatment, infected patients should clear infection within 2 months
- Death associated with opportunistic co-infection.
Human monocytotropic ehrlichiosis
- HME is a severe illness with many complications
- Even in the presence of proper medical therapy, nearly 2.7% of infected patients will die
- Infection must be closely monitored in order to reduce the amount of possible complications
References
- ↑ Thomas, Rachael J (1 August 2009). "Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and ehrlichiosis". Expert Review of Anti-infective Therapy. 7 (6): 709–722. doi:10.1586/eri.09.44. PMC 2739015. PMID 19681699. Unknown parameter
|month=ignored (help); Unknown parameter|coauthors=ignored (help)