Ehrlichiosis and anaplasmosis

Ehrlichiosis and anaplasmosis, of all types, are nationally notifiable diseases.

Seasonality is due to higher likelihood of tick exposure/bite when people spend more time outdoors in warmer months.

Presumptive diagnosis is made in patients with potential tick exposure/demonstrated tick bite combined with fever and other characteristic constitutional symptoms plus leukopenia and/or thrombocytopenia and elevated LFTs. Serology or polymerase chain reaction confirms diagnosis.

Treatment with antibiotics should be started immediately if the diagnosis is suspected clinically. Doxycycline is the drug of choice.

Tick-borne emerging infections of white blood cells are most commonly caused by 3 different gram-negative bacteria from the Anaplasmataceae family: Ehrlichia ewingii, E chaffeensis, and Anaplasma phagocytophilum. Ehrlichia muriseauclairensis (formerly known as Ehrlichia muris-like agent, EMLA) also causes symptomatic infection and is the most recently recognized form of human ehrlichiosis. The type of infection that develops depends on the infecting bacteria and includes human monocytotropic/monocytic ehrlichiosis (HME), human granulocytotropic/granulocytic anaplasmosis (HGA), and human ewingii ehrlichiosis (HEE). The clinical manifestations of each type are generally the same. This topic deals with human infection only.​​