Ehrlichiosis: Difference between revisions
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=Background= | ==Background== | ||
*Spread by the | *Bacterial infection of the family Anaplasmataceae | ||
*Spread by the Lon1estar tick (Amblyomma americanum) | |||
**Eastern seaboard from Florida to Maine and as far west as Iowa and Texas | **Eastern seaboard from Florida to Maine and as far west as Iowa and Texas | ||
**People often unaware they are bitten | **People often unaware they are bitten | ||
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**More severe disease in immunocompromized patients (HIV, Elderly, '''Asplenic''') | **More severe disease in immunocompromized patients (HIV, Elderly, '''Asplenic''') | ||
=Symptoms= | ==Symptoms== | ||
*Fever, chills, headache, malaise, myalgias, nausea, vomiting, diarrhea, conjunctival injection | *Fever, chills, headache, malaise, myalgias, nausea, vomiting, diarrhea, conjunctival injection | ||
**Up to 60% of children may have a rash (30% of adults) | **Up to 60% of children may have a rash (30% of adults) | ||
=Diagnosis= | ==Diagnosis== | ||
*Obligate intracellular organism | *Obligate intracellular organism | ||
**Peripheral blood smear shows intracellular parasites only 20% of time | **Peripheral blood smear shows intracellular parasites only 20% of time | ||
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**Qualitative tests, not quantitative | **Qualitative tests, not quantitative | ||
=Treatment= | ==Treatment== | ||
*Doxycycline | *Doxycycline | ||
**100mg BID (Adults) | **100mg BID (Adults) | ||
**2.2mg/kg BID (children) | **2.2mg/kg BID (children) | ||
=Sources= | ==See also== | ||
[[tick borne illnesses]] | |||
==Sources== | |||
*Wikipedia | *Wikipedia | ||
*cdc.gov/parastites/ehrlichiosis | *cdc.gov/parastites/ehrlichiosis | ||
Revision as of 04:03, 9 December 2013
Background
- Bacterial infection of the family Anaplasmataceae
- Spread by the Lon1estar tick (Amblyomma americanum)
- Eastern seaboard from Florida to Maine and as far west as Iowa and Texas
- People often unaware they are bitten
- Case fatality rate is approximately 1.8%
- More severe disease in immunocompromized patients (HIV, Elderly, Asplenic)
Symptoms
- Fever, chills, headache, malaise, myalgias, nausea, vomiting, diarrhea, conjunctival injection
- Up to 60% of children may have a rash (30% of adults)
Diagnosis
- Obligate intracellular organism
- Peripheral blood smear shows intracellular parasites only 20% of time
- PCR
- Most sensitive in first week of illness
- Indirect Immunoflorescence Assay
- Gold Standard
- Negative 85% of time in first 7 days of illness
- Compare 2 samples drawn at different times
- 4 fold increase in titers of second draw is positive
- Enzyme Immunoassay
- Qualitative tests, not quantitative
Treatment
- Doxycycline
- 100mg BID (Adults)
- 2.2mg/kg BID (children)
See also
Sources
- Wikipedia
- cdc.gov/parastites/ehrlichiosis
- uptodate.com