Ehrlichiosis and anaplasmosis

Last reviewed: 1 Nov 2022
Last updated: 21 May 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • headache
  • malaise
  • myalgia
  • arthralgia
  • nausea
  • small erythematous lesion with or without necrotic centre
  • non-specific rash
More key diagnostic factors

Other diagnostic factors

  • vomiting
  • diarrhoea
  • abdominal pain
  • cough
  • dyspnoea
  • stiff neck
  • confusion
  • photophobia
  • stupor
  • coma
  • seizures
  • lymphadenopathy
  • jaundice
  • hepatomegaly
  • splenomegaly
  • secondary infections
Other diagnostic factors

Risk factors

  • tick bite/exposure
  • immunosuppression
  • age over 60 years
  • male sex
More risk factors

Diagnostic investigations

1st investigations to order

  • FBC
  • LFTs
  • peripheral blood smear
More 1st investigations to order

Investigations to consider

  • immunofluorescence antibody assay
  • polymerase chain reaction
More investigations to consider

Emerging tests

  • Western immunoblotting
  • culture
  • immunohistochemistry

Treatment algorithm

INITIAL

adults

children

Contributors

Authors

Juan P. Olano, MD

Professor

Department of Pathology

University of Texas Medical Branch

Galveston

TX

Disclosures

JPO is the author of a number of references cited in this topic.

Peer reviewers

Linda S. Nield, MD

Associate Professor of Pediatrics

West Virginia University School Of Medicine

Morgantown

WV

Disclosures

LSN declares that she has no competing interests.

Richard Reithinger, MD, PhD

Professor

London School of Hygiene and Tropical Medicine

London

UK

Disclosures

RR declares that he has no competing interests.

  • Ehrlichiosis and anaplasmosis images
  • Differentials

    • Pneumonia, bacterial or viral
    • Gastroenteritides, bacterial or viral
    • Cholecystitis
    More Differentials
  • Guidelines

    • CDC health information for international travel: rickettsial diseases (including spotted fever & typhus fever, rickettsioses, scrub typhus, anaplasmosis, and ehrlichiosis)
    • Tickborne diseases of the United States: a reference manual for health care providers
    More Guidelines
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