Ehrlichiosis

Ehrlichiosis

Chris Schach

Author Bio -

Key Points
*Condition is a white blood cell infection caused by bacteria transmitted via tick bites.
*Condition may appear symptom free or be mild, but symptoms are severely flu-like.
*Condition may cause rashes which also vary in severity and distribution.

Ehrlichiosis (also called human monocytic Ehrlichiosis) is a white blood cell infection caused by the bacteria Ehrlichia Chaffeensis and Ehrlichia Ewingii. Ehrlichiosis is transmitted via the bite of an infected tick; Amblyomma Americanum (Lone Star tick) is the principle tick. Ehrlichiosis is most commonly diagnosed from spring through autumn.

Historically, the term Ehrlichiosis also encompassed a very similar tick-borne disease called Anaplasmosis.
Many people with Ehrlichiosis and Anaplasmosis may be symptom-free or have only very mild symptoms. Symptomatic patients may experience fever, fatigue, chills, severe headaches, muscle aches, nausea, vomiting, and loss of appetite. These symptoms generally begin after a 5-21 day incubation period. Blood count abnormalities such as low white cell count and low platelet count may occur. In patients with impaired immunity, Ehrlichiosis and Anaplasmosis may be more severe.

Rashes may appear in people with Ehrlichiosis. When present, the rash takes various forms. It has been described as red, small red or purple spots due to bleeding into the skin, flat discolorations, and having small lumps. Less commonly, lesions are described as blistering, having larger solid lumps, purplish, mottled, blotchy, crusted, or ulcerated. A single patient may display multiple types of lesions. In severe cases, a widespread rash and shedding of the skin in scales can fit criteria for Toxic shock syndrome. The rash appears from day 0 to 13 of the illness. The rash has a variable distribution over the body, but the palms and soles are rarely involved.

Differential Diagnosis (Other conditions with similar appearance)

    Anaplasmosis
    Babesiosis
    Malaria
    Meningitis
    Rocky Mountain spotted fever
    Typhoid Fever

    Diagnosis
    Key Points
    *Diagnosis is determined through blood testing and clinical inspection.

    Diagnosis is determined through blood testing and clinical inspection to determine the presence of the bacteria.

    Treatment
    Key Points
    *Tetracycline Antibiotics are suggested for the treatment of Ehrlichiosis.
    *Basic tick safety is a useful preventative measure.

    A tetracycline antibiotic, usually Doxycycline, is recommended for the treatment of Ehrlichiosis and Anaplasmosis. Chloramphenicol can be used in patients unable to take tetracyclines. Basic tick safety — insect repellents, long sleeves and pants, care in forested areas — will also help prevent further infection.

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