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==Natural History, Complications and Prognosis==


===Complications===
==Natural History==
Infection varies according to the Ehrlichiae agent responsible for the infection. Listed below are the progressive pathways of each infection:
 
===HGE===
====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.
 
 
===HME===
====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==
* [[Acute respiratory distress syndrome|Respiratory distress syndrome]]
* [[Acute respiratory distress syndrome|Respiratory distress syndrome]]
* [[Hepatitis]]
* [[Hepatitis]]
Line 15: Line 49:
* Opportunistic [[nosocomial infection]]s<ref>{{cite journal|last=Thomas|first=Rachael J|coauthors=Dumler, J Stephen, Carlyon, Jason A|title=Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and ehrlichiosis|journal=Expert Review of Anti-infective Therapy|date=1 August 2009|year=2009|month=August|volume=7|issue=6|pages=709–722|doi=10.1586/eri.09.44|pmid=19681699|pmc=2739015}}</ref>
* Opportunistic [[nosocomial infection]]s<ref>{{cite journal|last=Thomas|first=Rachael J|coauthors=Dumler, J Stephen, Carlyon, Jason A|title=Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and ehrlichiosis|journal=Expert Review of Anti-infective Therapy|date=1 August 2009|year=2009|month=August|volume=7|issue=6|pages=709–722|doi=10.1586/eri.09.44|pmid=19681699|pmc=2739015}}</ref>
* [[Death]]
* [[Death]]
==Prognosis==
===HGE===
*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.
===HME===
*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==
==References==

Revision as of 16:32, 18 January 2016

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Natural History

Infection varies according to the Ehrlichiae agent responsible for the infection. Listed below are the progressive pathways of each infection:

HGE

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.


HME

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

Prognosis

HGE

  • 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.

HME

  • 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

  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)
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