Ehrlichiosis: Difference between revisions

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==Epidemiology and Demographics==
* The average reported annual [[incidence]] is 0.7 cases per million population.<ref name="Goddard">{{cite journal |author=Goddard J |title=What Is New With Ehrlichiosis?|journal=Infections in Medicine|date=September 1, 2008|url=http://www.consultantlive.com/headache/article/1145625/1405478}}</ref>
* ''A. phagocytophilium'' is endemic to New England and the north central and Pacific regions of the United States.
* ''E. chaffeensis'' is most common in the south central and southeastern states.
* ''E. ewingii'' is most common in the south central and southeastern states.
The lone star tick (''Amblyomma americanum'') is the primary vector of both ''Ehrlichia chaffeensis'' and ''Ehrlichia ewingii'' in the United States <ref name= "CDC main page"> </ref>.


==Risk Factors==
==Risk Factors==

Revision as of 17:02, 6 August 2015

Ehrlichiosis
ICD-10 A79.8
ICD-9 082.4
DiseasesDB 31663
MedlinePlus 001381
MeSH D016873
This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Ehrlichia.

Ehrlichiosis Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ehrlichiosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

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Case Studies

Case #1

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For patient information on this page, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Synonyms and keywords: Sennetsu fever; human granulocytic ehrlichiosis; Anaplasma phagocytophilum; Ehrlichia phagocytophila; human monocytic ehrlichiosis

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ehrlichiosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Future or Investigational Therapies

Case Studies

Case#1


Risk Factors

Risk factors for ehrlichiosis include:

  • Living near an area with a lot of ticks
  • Owning a pet that may bring a tick home
  • Walking or playing in high grasses

Natural History, Complications and Prognosis

Complications

Diagnosis

Symptoms

Other possible symptoms include:

A rash appears in fewer than half of cases.

Physical Examination

Vitals

Skin

Head

Laboratory Findings

Treatment

  • Early clinical experience suggested that chloramphenicol may also be effective, however in vitro susceptibility testing revealed resistance.

Antimicrobial regimen

  • Preferred regimen: Doxycycline 100 mg PO/IV q12h for 7-14 days
  • Note: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement
  • Alternative regimen (1): Chloramphenicol 500mg PO qid
  • Alternative regimen (2): Rifampin 600 mg PO/IV qd for 7-10 days
  • 2.1 ≥ 8 years old
  • Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 10 days
  • 2.2 < 8 years old without Lyme disease
  • Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (Maximum, 200 mg/day) for 4-5 days (or 3 days after resolution of fever)
  • 2.3 co-infected with Lyme disease
  • Preferred regimen: Doxycycline, then Amoxicillin 50 mg/kg in 3 divided doses (Maximum, 500 mg/dose) OR Cefuroxime 30 mg/kg in 2 divided doses (Maximum, 500 mg/dose) for 14 days

References

  1. 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)
  2. Marty AM, Dumler JS, Imes G, Brusman HP, Smrkovski LL, Frisman DM (1995). "Ehrlichiosis mimicking thrombotic thrombocytopenic purpura. Case report and pathological correlation". Hum. Pathol. 26 (8): 920–5. doi:10.1016/0046-8177(95)90017-9. PMID 7635455. Unknown parameter |month= ignored (help)
  3. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.


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