Ehrlichiosis
| Ehrlichiosis | |
| ICD-10 | A79.8 |
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| ICD-9 | 082.4 |
| DiseasesDB | 31663 |
| MedlinePlus | 001381 |
| MeSH | D016873 |
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Ehrlichiosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Ehrlichiosis On the Web |
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American Roentgen Ray Society Images of Ehrlichiosis |
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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
Diagnosis
Symptoms
Other possible symptoms include:
- Diarrhea
- Fine pinhead-sized areas of bleeding in the skin (petechial rash)
- Flat red rash (maculopapular rash)
- General ill feeling (malaise)
A rash appears in fewer than half of cases.
Physical Examination
Vitals
Skin
Head
Laboratory Findings
- Complete blood count (CBC)
- Granulocyte stain
- Fluorescent antibody test
Treatment
- Doxycycline is the drug of choice.
- For people allergic to drugs of the tetracycline class, rifampicin is an alternative.[2]
- Early clinical experience suggested that chloramphenicol may also be effective, however in vitro susceptibility testing revealed resistance.
Antimicrobial regimen
- 1. Human Monocytic Ehrlichiosis or Human Granulocytic Anaplasmosis (adult) [3]
- 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. Human Monocytic Ehrlichiosis or Human Granulocytic Anaplasmosis (pediatric)
- 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
- ↑ 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) - ↑
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.