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Human Ehrlichiosis - Essay Example

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Human ehrlichiosis was first described in the United States in 1986. Since then, more than 215 cases have been reported, including some fatalities. Ehrlichia species belong to the same family as the organism that causes Rocky Mountain spotted fever. Human ehrlichiosis occurs most frequently in the southern mid-Atlantic and south-central states, during spring and summer months…
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Download file to see previous pages Ehrlichiosis cannot reliably be distinguished from other common febrile illnesses on the basis of clinical, epidemiologic or laboratory features. Therapy must be initiated empirically in suspected cases. Both ehrlichiosis and Rocky Mountain spotted fever respond well to tetracycline and chloramphenicol, but not to penicillins or cephalosporins.
Ehrlichiosis is caused by rickettsiae like organisms, which are intracellular parasites. Co-infection with babesiosis and/or Lyme disease may occur. Human monocytic ehrlichiosis is caused by Ehrlichia (E.) chaffeensis. (David A. Poirier, Kenneth L. Feder, 2001)
Ehrlichiosis is transmitted by the bite of infected ticks, including the deer tick and the lone star tick. Ehrlichiosis cannot be spread from person to person.
The American dog tick, lone star tick, and probably the Western black-legged tick transmit the infection. Most cases are reported from the south central and southeastern United States. Human granulocytic ehrlichiosis is a related variation that is probably caused by an E. equi- related strain. It's transmitted by the black-legged tick and probably the Western black-legged and American dog ticks. Cases have been found nationwide. (David A. Poirier, Kenneth L. Feder, 2001)
The epidemiology, response to antibiotics and cl...
ky Mountain spotted fever are similar but not identical, and these diseases must be differentiated from other febrile illnesses in patients who have a history of possible tick exposure. The diagnosis is currently based on antibody response in acute and convalescent sera and cannot be made with certainty on the basis of clinical features alone. Therefore, appropriate antibiotic therapy must be initiated empirically. (Bolan, Charles D, 1992)
In the United States, human ehrlichioses may be caused by at least 3 distinct species of obligate intracellular bacteria. Human monocytic ehrlichiosis results from infection with E chaffeensis. Human granulocytic ehrlichiosis is caused by A phagocytophila and E ewingii. Ehrlichia species are gram-negative cocci that measure 0.5 to 1.5 m in diameter.
Typical signs and symptoms
Fever, malaise, headache, chills, severe muscle aches/pain, vomiting, anemia, lung infection, decrease in white blood cells, decrease in platelets, and elevated liver enzymes. A rash occurs in a small percentage of people. Neurologic symptoms include seizures, encephalopathy, meningitis, confusion, atazia, and change in mental status. Symptoms can also be nonspecific. (David A. Poirier, Kenneth L. Feder, 2001)
Symptoms typically last 1 to 2 weeks, and recovery generally occurs without sequelae; however, reports suggest the occurrence of neurologic complications in some children after severe disease. Fatal infections have been reported. Secondary or opportunistic infections may occur in severe illness, resulting in possible delayed recognition of ehrlichiosis and appropriate antimicrobial treatment. People with underlying immunosuppression are at greater risk of severe disease. ...Download file to see next pagesRead More
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