Materiały źródłowe

• #1 Mayo Clinic Health Library – Ehrlichiosis and anaplasmosis | Swiss Medical Network

  https://www.swissmedical.net/it/healtcare-library/con-20372124

  Ehrlichiosis and anaplasmosis are similar tick-borne illnesses that cause flu-like symptoms, including fever, muscle aches and headache. Signs and symptoms of ehrlichiosis and anaplasmosis usually appear within 14 days after a tick bite. […] If treated quickly with appropriate antibiotics, you’ll likely recover within a few days. Untreated ehrlichiosis and anaplasmosis can result in serious or life-threatening complications. […] Signs and symptoms of ehrlichiosis and anaplasmosis are generally the same, although they usually are more severe in ehrlichiosis. Symptoms of ehrlichiosis and anaplasmosis, which vary widely from person to person, include: Moderate fever, Chills, Headache, Muscles aches or pains, General feeling of being unwell, Joint pain, Nausea, Vomiting, Diarrhea, Loss of appetite.

• #1 Ehrlichiosis and Anaplasmosis – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/rickettsial-and-related-infections/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are tick-borne bacterial infections that cause fever, chills, muscle aches, headache, a general feeling of illness (malaise), and sometimes a rash. […] Symptoms of ehrlichiosis and anaplasmosis are similar, but anaplasmosis is less likely to cause a rash. […] Symptoms usually begin about 12 days after a tick bite. Symptoms begin suddenly. They include fever, chills, muscle aches, weakness, nausea and/or vomiting, cough, headache, and malaise. […] A rash may develop on the torso, arms, and legs in some people with ehrlichiosis but is uncommon in people with anaplasmosis. Some people have no symptoms. […] Ehrlichiosis and anaplasmosis may cause widespread blood clotting (disseminated intravascular coagulation), severe malfunction (failure) of several organs, seizures, and coma. […] Symptoms of both infections are more severe in people with a weakened immune system (due to a disorder such as HIV infection or to medications such as corticosteroids). Death is uncommon but is more likely to occur in people with a weakened immune system or who are not treated soon enough.

• #1 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  Three basic types of ehrlichiosis have been observed in the US: Ehrlichia chaffeensis, the agent of human monocytic ehrlichiosis; E ewingii, the agent of canine granulocytic ehrlichiosis; and A phagocytophilum, the agent of human anaplasmosis (formerly called human granulocytic ehrlichiosis). The symptoms of these diseases are similar to those of Rocky Mountain spotted fever, with the exception that a rash is less common in ehrlichiosis or anaplasmosis. […] Symptoms of human monocytic ehrlichiosis include fever, headache, malaise, and muscle aches. In children, particularly, a maculopapular or petechial rash can be seen later in the disease process; about 40-50% of adults will develop the rash. Other manifestations may include nausea, vomiting, diarrhea, cough, joint pain, and mental confusion. Important laboratory findings include leukopenia, thrombocytopenia, and elevated liver enzymes. If untreated, the disease can be severe; as many as 50% of all patients require hospitalization. Severe manifestations of the disease may include prolonged fever, renal failure, disseminated intravascular coagulopathy, meningoencephalitis, adult respiratory distress syndrome, seizures, or coma. Approximately 2-3% of untreated patients die from the infection.

• #1 Human Ehrlichiosis and Anaplasmosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2882064/

  Human ehrlichiosis and anaplasmosis are acute febrile tick-borne diseases caused by various members from the genera Ehrlichia and Anaplasma (Anaplasmataceae). […] Ehrlichia chaffeensis, the etiologic agent of human monocytotropic ehrlichiosis (HME) is an emerging zoonosis that causes clinical manifestations ranging from a mild febrile illness to a fulminant disease characterized by multi-organ system failure. […] HME and HGA have similar clinical presentations including fever, headache, leukopenia, thrombocytopenia and elevated liver enzymes. Symptoms typically begin a median of 9 days following tick bite, with the majority of patients seeking medical attention within the first 4 days of illness. […] The most frequent neurologic manifestation of HME is meningitis or meningoencephalitis. Central nervous system involvement is identified in approximately 20% of patients with HME, and in some cases may be associated with seizures and coma. […] HGA resembles HME with respect to the frequency of fever, headache, and myalgias, but rash is uncommon, noted in less than 10% of patients. […] Central nervous system involvement is uncommon in HGA, with meningoencephalitis reported in only approximately 1% of cases.

• #1 Ehrlichiosis and anaplasmosis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are similar tick-borne illnesses that cause flu-like symptoms, including fever, muscle aches and headache. Signs and symptoms of ehrlichiosis and anaplasmosis usually appear within 14 days after a tick bite. […] Signs and symptoms of ehrlichiosis and anaplasmosis are generally the same, although they usually are more severe in ehrlichiosis. Symptoms of ehrlichiosis and anaplasmosis, which vary widely from person to person, include: Moderate fever, Chills, Headache, Muscles aches or pains, General feeling of being unwell, Joint pain, Nausea, Vomiting, Diarrhea, Loss of appetite. […] Additional signs and symptoms associated with ehrlichiosis but rarely with anaplasmosis include: Confusion or changes in mental state, Rash. […] The time from getting a bite to showing signs and symptoms is usually five to 14 days. If you develop any of the signs or symptoms after a tick bite or after a possible exposure to ticks, see your doctor.

• #1 Ehrlichiosis and anaplasmosis | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20372124/

  Without prompt treatment, ehrlichiosis and anaplasmosis can have serious effects on an otherwise healthy adult or child. People with weakened immune systems are at a higher risk of more-serious and life-threatening complications. Complications of an untreated infection may include: Kidney failure, Respiratory failure, Heart failure, Damage to the central nervous system, Seizures, Coma, Severe secondary infections. […] If you have ehrlichiosis or anaplasmosis, the following results are likely found from blood tests: Low count of white blood cells, which are disease-fighting cells of the immune system, Low count of blood platelet cells, which are essential for blood-clotting, Elevated liver enzymes that may indicate abnormal liver function. […] If your doctor diagnoses ehrlichiosis or anaplasmosis or suspects a diagnosis based on the symptoms and clinical findings you’ll begin treatment with the antibiotic doxycycline (Doryx, Vibramycin, others). You’ll take the drugs at least three days after you no longer have a fever and your doctor has observed improvement in other signs of disease. The minimum treatment is five to seven days. More serious illness may require two to three weeks of antibiotic treatment.

• #1 Elanco Logo

  https://yourpetandyou.elanco.com/us/parasites/ehrlichiosis-and-anaplasmosis-in-dogs

  Ehrlichiosis is an infectious disease transmitted by ticks carrying bacteria in the Ehrlichia genus. The bacteria infects white blood cells and impacts blood platelets. The disease appears to be particularly severe in Doberman pinschers, German shepherds, Belgium Malinois and Siberian huskies. […] Symptoms of Ehrlichiosis in dogs present in three phases: acute, subclinical and chronic. […] Acute Phase: Fever, Swollen lymph nodes, Loss of appetite, Lethargy, Respiratory distress, Bleeding disorders (including nosebleeds). […] If not treated or eliminated by the dogs immune system, the illness will pass into the subclinical phase. This phase is considered the most dangerous phase as the disease does not present any symptoms, making it undetectable and able to progress without treatment.

• #1 Elanco Logo

  https://yourpetandyou.elanco.com/us/parasites/ehrlichiosis-and-anaplasmosis-in-dogs

  If the infection remains untreated, it will enter the chronic phase. In this phase symptoms will become more intense and more difficult to treat. These symptoms include: Anemia, Lameness, Bleeding episodes, Swollen limbs, Vision loss. […] Like ehrlichiosis, anaplasmosis is a tick-borne disease that infects a dogs bloodstream. The most common form of the disease, Anaplasma phagocytophilum, infects white blood cells and is transmitted by deer ticks. […] Dogs suffering from anaplasmosis may display a range of nonspecific symptoms beginning up to a week after infection. Anaplasmosis symptoms may include: Fever, Lethargy, Lack of appetite, Malaise, Joint pain and lameness, Vomiting, Diarrhea, Coughing, Labored breathing, Seizures, Ataxia (lack of muscle and movement control). […] Because its symptoms are similar to Lyme disease and other tick-borne illnesses, it can be difficult to diagnose anaplasmosis.

• #1 Mayo Clinic Health Library – Ehrlichiosis and anaplasmosis | Swiss Medical Network

  https://www.swissmedical.net/it/healtcare-library/con-20372124

  Additional signs and symptoms associated with ehrlichiosis but rarely with anaplasmosis include: Confusion or changes in mental state, Rash. […] The time from getting a bite to showing signs and symptoms is usually five to 14 days. If you develop any of the signs or symptoms after a tick bite or after a possible exposure to ticks, see your doctor. […] Without prompt treatment, ehrlichiosis and anaplasmosis can have serious effects on an otherwise healthy adult or child. People with weakened immune systems are at a higher risk of more-serious and life-threatening complications. […] Complications of an untreated infection may include: Kidney failure, Respiratory failure, Heart failure, Damage to the central nervous system, Seizures, Coma, Severe secondary infections.

• #1 Rickettsial Infections: Ehrlichia, Anaplasma, and Rocky Mountain Spotted Fever – Project Lyme

  https://projectlyme.org/resource/ehrlichia-anaplasma-and-rocky-mountain-spotted-fever/

  Other symptoms that can accompany the infections are: Flu-like illness, Joint pain, Disorientation, Stomach aches, Nausea and vomiting, Weight loss, Respiratory distress, Low white blood cell count, Anemia, Increased liver enzymes, Kidney failure. […] Those who are most prone to severe illness and require hospitalizations from Ehrlichia, Anaplama, and RMSF include the elderly, immunocompromised individuals, and people who have experienced a delay in treatment, states the CDC.

• #1 Ehrlichiosis | Lyme Disease

  https://www.columbia-lyme.org/ehrlichiosis

  Patients are most likely to be infected with Ehrlichia in spring and summer months, though cases occur into autumn as well. […] Most patients develop symptoms one to two weeks after the tick bite, and over 70% will have fever, chills, severe headache, and myalgias. Less common symptoms include nausea and vomiting, as well as confusion. A maculopapular rash (easily distinguishable from Rocky Mountain spotted fever) can also occur. […] Although most cases of HME are uncomplicated, it is a potentially serious illness. Hospitalization rates in symptomatic patients are estimated to be 40-50%, and fatalities run in the 2-3% range. […] The main complications of ehrlichiosis are prolonged fever, a toxic or septic shock-like syndrome, coagulopathy, adult respiratory distress syndrome, and central nervous system manifestations such as meningoencephalitis, seizures and coma. Peripheral neuropathies, primarily cranial neuritis, are rarer, but have also been reported.

• #1 Ehrlichiosis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/ehrlichiosis

  Ehrlichiosis is a bacterial infection transmitted by the bite of a tick. […] The incubation period between the tick bite and when symptoms occur is about 7 to 14 days. Symptoms may seem like the flu (influenza), and may include: Fever and chills, Headache, Muscle aches, Nausea. […] A rash appears in fewer than one third of cases. Sometimes, the disease may be mistaken for Rocky Mountain spotted fever, if the rash is present. The symptoms are often mild, but people are sometimes sick enough to see a health care provider. […] Ehrlichiosis is rarely deadly. With antibiotics, people usually improve within 24 to 48 hours. Recovery may take up to 3 weeks.

• #1 Ehrlichiosis, Anaplasmosis, and Related Infections in Animals – Infectious Diseases – Merck Veterinary Manual

  https://www.merckvetmanual.com/infectious-diseases/rickettsial-diseases/ehrlichiosis-anaplasmosis-and-related-infections-in-animals

  In acute cases receiving appropriate antibiotic therapy, body temperature is expected to return to normal within 24-48 hours after treatment. […] In chronic cases associated with E canis infection, the hematologic abnormalities may persist for 3-6 months, although clinical response to treatment often occurs much sooner.

• #1 Tickborne Diseases: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0501/p530.html

  Signs and symptoms of ehrlichiosis and anaplasmosis include fever, chills, headaches, and myalgias. Gastrointestinal symptoms, including nausea and vomiting, may be prominent. Symptoms appear five to 14 days after exposure. Rash ranging from maculopapular to petechial to diffuse erythema occurs in up to one-third of people infected with Ehrlichia chaffeensis and presents more often in children than adults. Anaplasmosis rarely presents with a rash. Late manifestations of untreated illness include meningoencephalitis, respiratory failure, uncontrolled bleeding, and organ failure. The fatality rate is 3% with ehrlichiosis and less than 1% with HGA. […] The diagnosis of erhlichiosis and HGA should be considered in patients with flulike symptoms with gastrointestinal predominance and associated laboratory findings of leukopenia, thrombocytopenia, and elevated transaminases. Confirmative testing should not delay treatment. Polymerase chain reaction (PCR) or the presence of morulae on blood smear are helpful if positive; however, negative results do not rule out disease. The preferred method for confirming either disease is IFA. Similar to the evaluation of RMSF, paired acute and convalescent serologies should be obtained two to four weeks apart. A fourfold increase in IgG titers is diagnostic. […] The treatment of choice for ehrlichiosis and anaplasmosis is doxycycline for a minimum of 10 days, continuing for at least three days after resolution of the fever. The benefits of doxycycline outweigh the risks, even in pregnant women and children. Early treatment is imperative.

• #2 Anaplasmosis and Ehrlichiosis Fact Sheet

  https://www.health.ny.gov/diseases/communicable/ehrlichiosis/fact_sheet.htm

  Anaplasmosis and Ehrlichiosis are two closely related tick-borne bacterial diseases spread by the bite of infected ticks. […] The symptoms are the same for both and may include fever, muscle aches, weakness, and headache. Patients may also experience confusion, nausea (the feeling of sickness in the stomach), vomiting, and joint pain. […] Infection usually produces mild to moderately severe illness, with high fever and headache, but may occasionally be life threatening or even fatal. Symptoms appear one to two weeks after the bite of an infected tick. However, not every bite from an infected tick results in infection.

• #2 Ehrlichiosis and anaplasmosis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are similar tick-borne illnesses that cause flu-like symptoms, including fever, muscle aches and headache. Signs and symptoms of ehrlichiosis and anaplasmosis usually appear within 14 days after a tick bite. […] Signs and symptoms of ehrlichiosis and anaplasmosis are generally the same, although they usually are more severe in ehrlichiosis. Symptoms of ehrlichiosis and anaplasmosis, which vary widely from person to person, include: Moderate fever, Chills, Headache, Muscles aches or pains, General feeling of being unwell, Joint pain, Nausea, Vomiting, Diarrhea, Loss of appetite. […] Additional signs and symptoms associated with ehrlichiosis but rarely with anaplasmosis include: Confusion or changes in mental state, Rash. […] The time from getting a bite to showing signs and symptoms is usually five to 14 days. If you develop any of the signs or symptoms after a tick bite or after a possible exposure to ticks, see your doctor.

• #2 Human Ehrlichiosis and Anaplasmosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2882064/

  Human ehrlichiosis and anaplasmosis are acute febrile tick-borne diseases caused by various members from the genera Ehrlichia and Anaplasma (Anaplasmataceae). […] Ehrlichia chaffeensis, the etiologic agent of human monocytotropic ehrlichiosis (HME) is an emerging zoonosis that causes clinical manifestations ranging from a mild febrile illness to a fulminant disease characterized by multi-organ system failure. […] HME and HGA have similar clinical presentations including fever, headache, leukopenia, thrombocytopenia and elevated liver enzymes. Symptoms typically begin a median of 9 days following tick bite, with the majority of patients seeking medical attention within the first 4 days of illness. […] The most frequent neurologic manifestation of HME is meningitis or meningoencephalitis. Central nervous system involvement is identified in approximately 20% of patients with HME, and in some cases may be associated with seizures and coma. […] HGA resembles HME with respect to the frequency of fever, headache, and myalgias, but rash is uncommon, noted in less than 10% of patients. […] Central nervous system involvement is uncommon in HGA, with meningoencephalitis reported in only approximately 1% of cases.

• #2 Ehrlichiosis | Lyme Disease

  https://www.columbia-lyme.org/ehrlichiosis

  Patients are most likely to be infected with Ehrlichia in spring and summer months, though cases occur into autumn as well. […] Most patients develop symptoms one to two weeks after the tick bite, and over 70% will have fever, chills, severe headache, and myalgias. Less common symptoms include nausea and vomiting, as well as confusion. A maculopapular rash (easily distinguishable from Rocky Mountain spotted fever) can also occur. […] Although most cases of HME are uncomplicated, it is a potentially serious illness. Hospitalization rates in symptomatic patients are estimated to be 40-50%, and fatalities run in the 2-3% range. […] The main complications of ehrlichiosis are prolonged fever, a toxic or septic shock-like syndrome, coagulopathy, adult respiratory distress syndrome, and central nervous system manifestations such as meningoencephalitis, seizures and coma. Peripheral neuropathies, primarily cranial neuritis, are rarer, but have also been reported.

• #2 Anaplasmosis | Lyme Disease

  https://www.columbia-lyme.org/anaplasmosis

  The clinical course of HGA ranges from asymptomatic infection to fatal disease. Initial symptoms, occurring about five to ten days after tick bite, are largely non-specific: fever, chills, severe headache, and myalgias; nausea, cough, and arthralgias may also occur. Rash is uncommon but has been reported. […] Compared with HME, HGA appears less likely to involve the central nervous system, but peripheral neuropathies (e.g., numbness and tingling) are more common and can last weeks to months. Among the neurologic findings reported in the medical literature are facial palsy, demyelinating polyneuropathy, and brachial plexopathy. Respiratory distress syndrome and a septic or toxic shock-like syndrome have been reported, but appear to be less common than in HME. The overall fatality rate from HGA is very low (less than 1%), with most of the deaths resulting from opportunistic infections (for example, herpes simplex esophagitis, Candida pneumonitis, and pulmonary aspergillosis) in immunocompromised patients.

• #2 Mayo Clinic Health Library – Ehrlichiosis and anaplasmosis | Swiss Medical Network

  https://www.swissmedical.net/it/healtcare-library/con-20372124

  Additional signs and symptoms associated with ehrlichiosis but rarely with anaplasmosis include: Confusion or changes in mental state, Rash. […] The time from getting a bite to showing signs and symptoms is usually five to 14 days. If you develop any of the signs or symptoms after a tick bite or after a possible exposure to ticks, see your doctor. […] Without prompt treatment, ehrlichiosis and anaplasmosis can have serious effects on an otherwise healthy adult or child. People with weakened immune systems are at a higher risk of more-serious and life-threatening complications. […] Complications of an untreated infection may include: Kidney failure, Respiratory failure, Heart failure, Damage to the central nervous system, Seizures, Coma, Severe secondary infections.

• #2 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Clinically, ehrichiosis presents many common symptoms and signs with rickettsial infections and may share overlapping geographic distribution. Clinicians should consider Ehrlichia infections when evaluating patients with flu-like illnesses in endemic areas. Due to the expanding geographic range of the ticks and the reservoirs of the species that cause ehrlichiosis, it is essential to be up-to-date regarding the changing epidemiology of Ehrlichia infections. Prompt administration of doxycycline significantly improves outcomes, and treatment should not be delayed pending diagnostic confirmation. Increased awareness, prompt diagnosis, and timely treatment are necessary for good patient outcomes. […] Symptoms may range from mild to severe and can even be fatal if not treated, especially if infected with E chaffeensis and A phagocytophilum. Patients who are older or immunocompromised may have worse outcomes if not treated promptly. Ehrlichiosis and anaplasmosis can also be transmitted through blood transfusions, which have been increasingly reported, especially in patients with hematological or solid tumor malignancies and transplantation.

• #2 Ehrlichiosis and Anaplasmosis – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/rickettsial-and-related-infections/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are tick-borne bacterial infections that cause fever, chills, muscle aches, headache, a general feeling of illness (malaise), and sometimes a rash. […] Symptoms of ehrlichiosis and anaplasmosis are similar, but anaplasmosis is less likely to cause a rash. […] Symptoms usually begin about 12 days after a tick bite. Symptoms begin suddenly. They include fever, chills, muscle aches, weakness, nausea and/or vomiting, cough, headache, and malaise. […] A rash may develop on the torso, arms, and legs in some people with ehrlichiosis but is uncommon in people with anaplasmosis. Some people have no symptoms. […] Ehrlichiosis and anaplasmosis may cause widespread blood clotting (disseminated intravascular coagulation), severe malfunction (failure) of several organs, seizures, and coma. […] Symptoms of both infections are more severe in people with a weakened immune system (due to a disorder such as HIV infection or to medications such as corticosteroids). Death is uncommon but is more likely to occur in people with a weakened immune system or who are not treated soon enough.

• #2 Ehrlichiosis in Dogs | VCA Animal Hospitals

  https://vcahospitals.com/know-your-pet/ehrlichiosis-in-dogs

  Signs of ehrlichiosis can be divided into three stages: acute (early disease), sub-clinical (no outward signs of disease), and clinical or chronic (long-standing infection). […] In this stage, infected dogs may have a fever, swollen lymph nodes, respiratory distress, weight loss, bleeding disorders (spontaneous hemorrhage or bleeding), and occasionally, neurological disturbances (they may seem unsteady or develop meningitis). This stage may last two to four weeks and some dogs may eliminate the infection or head into the sub-clinical phase. […] The sub-clinical phase represents the stage of infection in which the organism is present but is not causing any outward signs of disease. […] Clinical ehrlichiosis occurs if the immune system is not able to eliminate the organism. Dogs are likely to develop a host of problems such as anemia, bleeding episodes, lameness, eye problems (including hemorrhage or blindness), neurological problems, and swollen limbs. If the bone marrow (site of blood cell production) fails, the dog becomes unable to manufacture any of the blood cells necessary to sustain life.

• #2 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Patients with Ehrlichia infections, regardless of organism, typically present with nonspecific, flu-like symptoms such as fever, malaise, headache, body aches, and chills. Other findings may include gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and rash. Cough and respiratory symptoms are more common in adults compared to children. The central nervous system may also be involved, leading to symptoms such as a stiff neck and headache, along with cerebrospinal fluid analysis indicating meningitis and meningoencephalitis. […] In some patients who have more severe early symptoms or in those who have been left untreated, symptoms may progress to acute respiratory distress syndrome or sepsis or shock-like presentation with cardiovascular instability and coagulopathy. However, overall mortality is much lower in ehrlichiosis than in rickettsial disease but higher than in Lyme disease. The CDC reports a 1% to 3% mortality rate since 2000 in patients who present for medical care of ehrlichiosis. Anaplasmosis can be severe, with 36% of patients requiring hospitalization and 3% with life-threatening complications. Other reports have stated that up to 17% of hospitalized patients required admission to the intensive care unit. Many patients may be infected with ehrlichiosis but may not seek medical care, potentially leading to an overestimation of the mortality rate. Immunocompromised individuals, older adults, or those who have received pretreatment with sulfonamide antibiotics are predisposed to more severe illness.

• #2 Ehrlichiosis and anaplasmosis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/ehrlichiosis-and-anaplasmosis

  Without prompt treatment, ehrlichiosis and anaplasmosis can have serious effects on an otherwise healthy adult or child. People with weakened immune systems are at a higher risk of more-serious and life-threatening complications. Complications of an untreated infection may include: Kidney failure, Respiratory failure, Heart failure, Damage to the central nervous system, Seizures, Coma, Severe secondary infections.

• #2 Ehrlichiosis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/ehrlichiosis

  Ehrlichiosis is a bacterial infection transmitted by the bite of a tick. […] The incubation period between the tick bite and when symptoms occur is about 7 to 14 days. Symptoms may seem like the flu (influenza), and may include: Fever and chills, Headache, Muscle aches, Nausea. […] A rash appears in fewer than one third of cases. Sometimes, the disease may be mistaken for Rocky Mountain spotted fever, if the rash is present. The symptoms are often mild, but people are sometimes sick enough to see a health care provider. […] Ehrlichiosis is rarely deadly. With antibiotics, people usually improve within 24 to 48 hours. Recovery may take up to 3 weeks.

• #2 Tickborne Diseases: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0501/p530.html

  Signs and symptoms of ehrlichiosis and anaplasmosis include fever, chills, headaches, and myalgias. Gastrointestinal symptoms, including nausea and vomiting, may be prominent. Symptoms appear five to 14 days after exposure. Rash ranging from maculopapular to petechial to diffuse erythema occurs in up to one-third of people infected with Ehrlichia chaffeensis and presents more often in children than adults. Anaplasmosis rarely presents with a rash. Late manifestations of untreated illness include meningoencephalitis, respiratory failure, uncontrolled bleeding, and organ failure. The fatality rate is 3% with ehrlichiosis and less than 1% with HGA. […] The diagnosis of erhlichiosis and HGA should be considered in patients with flulike symptoms with gastrointestinal predominance and associated laboratory findings of leukopenia, thrombocytopenia, and elevated transaminases. Confirmative testing should not delay treatment. Polymerase chain reaction (PCR) or the presence of morulae on blood smear are helpful if positive; however, negative results do not rule out disease. The preferred method for confirming either disease is IFA. Similar to the evaluation of RMSF, paired acute and convalescent serologies should be obtained two to four weeks apart. A fourfold increase in IgG titers is diagnostic. […] The treatment of choice for ehrlichiosis and anaplasmosis is doxycycline for a minimum of 10 days, continuing for at least three days after resolution of the fever. The benefits of doxycycline outweigh the risks, even in pregnant women and children. Early treatment is imperative.

• #2 Anaplasmosis – National Collaborating Centre for Infectious Diseases

  https://nccid.ca/debrief/anaplasmosis/

  Anaplasmosis infections present with acute onset of fever, accompanied by one or more of the following symptoms or conditions: headache, malaise, myalgia, thrombocytopenia, leukopenia (initially attributed to lymphopenia in early infection) and elevated hepatic transaminases. Other less commonly observed symptoms are stiff neck, nausea, cough, anaemia, and increased serum creatine levels. The incubation period from tick bite to presenting with symptoms is between 5-21 days. […] In most cases, anaplasmosis is mild and self-limiting. Symptoms typically resolve within 30 days, even without treatment. However, more severe cases are observed in certain populations, such as older patients and individuals with compromised immunity, as well as those in whom diagnosis and treatment are delayed. […] The majority of symptoms typically will resolve within 30 days of onset, even without antibiotic treatment. There have been no reports of active clinical illness persisting beyond 60 days.

• #2 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  Three basic types of ehrlichiosis have been observed in the US: Ehrlichia chaffeensis, the agent of human monocytic ehrlichiosis; E ewingii, the agent of canine granulocytic ehrlichiosis; and A phagocytophilum, the agent of human anaplasmosis (formerly called human granulocytic ehrlichiosis). The symptoms of these diseases are similar to those of Rocky Mountain spotted fever, with the exception that a rash is less common in ehrlichiosis or anaplasmosis. […] Symptoms of human monocytic ehrlichiosis include fever, headache, malaise, and muscle aches. In children, particularly, a maculopapular or petechial rash can be seen later in the disease process; about 40-50% of adults will develop the rash. Other manifestations may include nausea, vomiting, diarrhea, cough, joint pain, and mental confusion. Important laboratory findings include leukopenia, thrombocytopenia, and elevated liver enzymes. If untreated, the disease can be severe; as many as 50% of all patients require hospitalization. Severe manifestations of the disease may include prolonged fever, renal failure, disseminated intravascular coagulopathy, meningoencephalitis, adult respiratory distress syndrome, seizures, or coma. Approximately 2-3% of untreated patients die from the infection.

• #2 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are caused by rickettsial-like bacteria. Symptoms resemble those of Rocky Mountain spotted fever except that a rash is much less common. Onset of illness, with fever, chills, headache, and malaise, is abrupt. […] Clinical features of ehrlichiosis and anaplasmosis are similar. Although some infections are asymptomatic, most cause abrupt onset of an influenza-like illness with nonspecific symptoms such as fever, chills, myalgias, weakness, nausea, vomiting, cough, headache, and malaise, usually beginning about 12 days after the tick bite. […] Rash is uncommon in anaplasmosis. Some patients infected with E. chaffeensis develop a maculopapular or petechial rash on the trunk and extremities. […] Ehrlichiosis and anaplasmosis may result in disseminated intravascular coagulation, multiorgan failure, seizures, and coma. […] Both infections appear to be more severe and have a higher mortality rate in patients with compromised immunity caused by immunosuppressants (eg, corticosteroids, cancer chemotherapy, long-term treatment with immunosuppressants after organ transplantation), HIV infection, or splenectomy.

• #2 Ehrlichiosis – American Lyme Disease Foundation

  https://aldf.com/227-2/

  Clinical manifestations of HME can range from mild to life-threatening depending on the patient’s age and general health. […] Onset of ehrlichiosis generally begins within a week of a tick bite, and often includes fever, severe headaches, malaise, muscle pains, and chills. Other symptoms may include nausea, vomiting, confusion and joint pain. A rash may appear in some HME cases but unlike Lyme disease, this rash is general in nature and is not associated with the site of the tick bite. […] Ehrlichiosis symptoms usually subside within 24-48 hours of treatment; if not, the physician should consider other diagnoses.

• #2 Ehrlichiosis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17958-ehrlichiosis

  Treatment is most effective when started soon after your symptoms appear. If its started too late, ehrlichiosis can cause serious complications that put you in the hospital. […] Most people make a full recovery from ehrlichiosis if treated quickly after symptoms start. Depending on how sick you are, you may need to be treated in the hospital. […] If not treated quickly enough, some people with ehrlichiosis have serious or life-threatening complications, including: Disseminated intravascular coagulation (DIC). Acute respiratory distress syndrome (ARDS) or respiratory failure. Renal failure (acute kidney injury). Internal bleeding (hemorrhaging). Sepsis. Brain inflammation (meningoencephalitis). Heart failure. Seizures. Coma. […] The outlook for ehrlichiosis is good if treated quickly. People who start antibiotics soon after their symptoms appear usually dont have serious complications. […] Ehrlichiosis can be fatal if you have serious complications. The fatality (death) rate for ehrlichiosis is 1%.

• #3 Ehrlichiosis and Anaplasmosis – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/rickettsial-and-related-infections/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are tick-borne bacterial infections that cause fever, chills, muscle aches, headache, a general feeling of illness (malaise), and sometimes a rash. […] Symptoms of ehrlichiosis and anaplasmosis are similar, but anaplasmosis is less likely to cause a rash. […] Symptoms usually begin about 12 days after a tick bite. Symptoms begin suddenly. They include fever, chills, muscle aches, weakness, nausea and/or vomiting, cough, headache, and malaise. […] A rash may develop on the torso, arms, and legs in some people with ehrlichiosis but is uncommon in people with anaplasmosis. Some people have no symptoms. […] Ehrlichiosis and anaplasmosis may cause widespread blood clotting (disseminated intravascular coagulation), severe malfunction (failure) of several organs, seizures, and coma. […] Symptoms of both infections are more severe in people with a weakened immune system (due to a disorder such as HIV infection or to medications such as corticosteroids). Death is uncommon but is more likely to occur in people with a weakened immune system or who are not treated soon enough.

• #3 Human Ehrlichiosis and Anaplasmosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2882064/

  Human ehrlichiosis and anaplasmosis are acute febrile tick-borne diseases caused by various members from the genera Ehrlichia and Anaplasma (Anaplasmataceae). […] Ehrlichia chaffeensis, the etiologic agent of human monocytotropic ehrlichiosis (HME) is an emerging zoonosis that causes clinical manifestations ranging from a mild febrile illness to a fulminant disease characterized by multi-organ system failure. […] HME and HGA have similar clinical presentations including fever, headache, leukopenia, thrombocytopenia and elevated liver enzymes. Symptoms typically begin a median of 9 days following tick bite, with the majority of patients seeking medical attention within the first 4 days of illness. […] The most frequent neurologic manifestation of HME is meningitis or meningoencephalitis. Central nervous system involvement is identified in approximately 20% of patients with HME, and in some cases may be associated with seizures and coma. […] HGA resembles HME with respect to the frequency of fever, headache, and myalgias, but rash is uncommon, noted in less than 10% of patients. […] Central nervous system involvement is uncommon in HGA, with meningoencephalitis reported in only approximately 1% of cases.

• #3 Ehrlichiosis and Anaplasmosis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/rickettsiae-and-related-organisms/ehrlichiosis-and-anaplasmosis

  Ehrlichiosis and anaplasmosis are caused by rickettsial-like bacteria. Symptoms resemble those of Rocky Mountain spotted fever except that a rash is much less common. Onset of illness, with fever, chills, headache, and malaise, is abrupt. […] Clinical features of ehrlichiosis and anaplasmosis are similar. Although some infections are asymptomatic, most cause abrupt onset of an influenza-like illness with nonspecific symptoms such as fever, chills, myalgias, weakness, nausea, vomiting, cough, headache, and malaise, usually beginning about 12 days after the tick bite. […] Rash is uncommon in anaplasmosis. Some patients infected with E. chaffeensis develop a maculopapular or petechial rash on the trunk and extremities. […] Ehrlichiosis and anaplasmosis may result in disseminated intravascular coagulation, multiorgan failure, seizures, and coma. […] Both infections appear to be more severe and have a higher mortality rate in patients with compromised immunity caused by immunosuppressants (eg, corticosteroids, cancer chemotherapy, long-term treatment with immunosuppressants after organ transplantation), HIV infection, or splenectomy.

• #3 Tick-borne Diseases | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/illness-and-disease-z/tick-borne-diseases

  Anaplasmosis is caused by a bacterium called Anaplasma phagocytophilum, typically transmitted by the bite of an infected black-legged tick. Symptoms typically begin within 1-2 weeks (up to 3 weeks) after the bite, and can include chills, fever, severe headache, muscle aches, nausea, vomiting, and diarrhea. These early symptoms are usually mild to moderate but can progress to severe illness if treatment is delayed or the person has a weakened immune system. […] If treatment is delayed, anaplasmosis may progress to severe disease, which can include respiratory failure, bleeding problems, organ failure, and, in less than one percent of cases, death. […] Ehrlichiosis refers to diseases caused by bacteria in the genus Ehrlichia; the majority of reported cases are due to infection with E. chaffeensis. Symptoms of ehrlichiosis typically begin within 1-2 weeks after the tick bite and can include fever, headaches, muscle aches, nausea and vomiting, diarrhea, confusion, and more commonly in children, rash. These early symptoms are usually mild to moderate, but can progress to severe illness if treatment is delayed or the person has a weakened immune system. […] If treatment is delayed, ehrlichiosis may progress to severe disease, which can include brain and nervous system damage, respiratory failure, uncontrolled bleeding, organ failure, and, in less than 2% of cases, death.

• #3 Ehrlichiosis in Dogs | VCA Animal Hospitals

  https://vcahospitals.com/know-your-pet/ehrlichiosis-in-dogs

  Signs of ehrlichiosis can be divided into three stages: acute (early disease), sub-clinical (no outward signs of disease), and clinical or chronic (long-standing infection). […] In this stage, infected dogs may have a fever, swollen lymph nodes, respiratory distress, weight loss, bleeding disorders (spontaneous hemorrhage or bleeding), and occasionally, neurological disturbances (they may seem unsteady or develop meningitis). This stage may last two to four weeks and some dogs may eliminate the infection or head into the sub-clinical phase. […] The sub-clinical phase represents the stage of infection in which the organism is present but is not causing any outward signs of disease. […] Clinical ehrlichiosis occurs if the immune system is not able to eliminate the organism. Dogs are likely to develop a host of problems such as anemia, bleeding episodes, lameness, eye problems (including hemorrhage or blindness), neurological problems, and swollen limbs. If the bone marrow (site of blood cell production) fails, the dog becomes unable to manufacture any of the blood cells necessary to sustain life.

• #3 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Complications of human monocytic ehrlichiosis and human granulocytic anaplasmosis may include respiratory and renal failure and neurological disease, such as coma and seizures. Early recognition and treatment of ehrlichiosis and other tick-borne diseases are crucial, as prompt antibiotic therapy significantly improves outcomes.

• #3 About Anaplasmosis | Anaplasmosis | CDC

  https://www.cdc.gov/anaplasmosis/about/index.html

  Signs and symptoms of anaplasmosis typically begin within 12 weeks after the bite of an infected tick. […] People with anaplasmosis will often have fever, headache, chills, and muscle aches. […] Early signs and symptoms (days 1-5) are usually mild or moderate and may include: Fever, chills, Severe headache, Muscle aches, Nausea, vomiting, diarrhea, loss of appetite. […] Signs and symptoms of severe (late stage) illness can include: Respiratory failure, Bleeding problems, Organ failure, Death. […] People with weakened immune systems are at risk for severe illness.

• #3 Ehrlichiosis

  https://www.atsu.edu/faculty/chamberlain/website/lectures/ehrlichiosis.htm

  Symptoms of canine granulocytic ehrlichiosis are similar to those of human monocytic ehrlichiosis. Disease usually is not seen in immunocompetent individuals. Most symptomatic infections are seen in people who have other medical conditions that cause immunosuppression (e.g., HIV infection, splenectomy, transplantation patients, and patients receiving immunosuppressive drugs). […] Symptoms of human anaplasmosis are similar to those of human monocytic ehrlichiosis and canine granulocytic ehrlichiosis; the rash is less common than in human monocytic ehrlichiosis and occurs in only 10% of patients. Severe illness, as seen with human monocytic ehrlichiosis and canine granulocytic ehrlichiosis, can also occur, especially if the disease is untreated. As many as 50% of all patients with human anaplasmosis require hospitalization. Without treatment, the fatality rate can be as high at 1%. […] Patients with compromised immunity caused by immunosuppressive therapies (e.g., corticosteroids or cancer chemotherapy), HIV infection, or splenectomy are more likely to develop severe disease following infection with any of these three pathogens.

• #3 Ehrlichiosis: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17958-ehrlichiosis

  Ehrlichiosis is an illness you get from a tick bite. Its caused by the bacteria Ehrlichia. Symptoms include fever, muscle aches and headache. Only about 30% of people (usually children) get a rash. Ehrlichiosis can cause serious complications if not treated quickly with antibiotics. […] Symptoms can start out mild and flu-like, but if not treated quickly, ehrlichiosis can be life-threatening. […] Symptoms of ehrlichiosis start five to 14 days after youre bitten. They usually start suddenly with flu-like symptoms and progress to additional symptoms. Rash from ehrlichiosis is more common in children than adults. […] Symptoms of ehrlichiosis include: Fever. Chills. Headache. Muscle pain or soreness. Tiredness. […] A few days later, you may get additional symptoms: Rash. Can be splotchy red patches or pinpoint dots. Cough. Nausea and vomiting. Stomach pain. Confusion.

• #3 Anaplasmosis | Lyme Disease

  https://www.columbia-lyme.org/anaplasmosis

  The clinical course of HGA ranges from asymptomatic infection to fatal disease. Initial symptoms, occurring about five to ten days after tick bite, are largely non-specific: fever, chills, severe headache, and myalgias; nausea, cough, and arthralgias may also occur. Rash is uncommon but has been reported. […] Compared with HME, HGA appears less likely to involve the central nervous system, but peripheral neuropathies (e.g., numbness and tingling) are more common and can last weeks to months. Among the neurologic findings reported in the medical literature are facial palsy, demyelinating polyneuropathy, and brachial plexopathy. Respiratory distress syndrome and a septic or toxic shock-like syndrome have been reported, but appear to be less common than in HME. The overall fatality rate from HGA is very low (less than 1%), with most of the deaths resulting from opportunistic infections (for example, herpes simplex esophagitis, Candida pneumonitis, and pulmonary aspergillosis) in immunocompromised patients.

• #3 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Patients with Ehrlichia infections, regardless of organism, typically present with nonspecific, flu-like symptoms such as fever, malaise, headache, body aches, and chills. Other findings may include gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and rash. Cough and respiratory symptoms are more common in adults compared to children. The central nervous system may also be involved, leading to symptoms such as a stiff neck and headache, along with cerebrospinal fluid analysis indicating meningitis and meningoencephalitis. […] In some patients who have more severe early symptoms or in those who have been left untreated, symptoms may progress to acute respiratory distress syndrome or sepsis or shock-like presentation with cardiovascular instability and coagulopathy. However, overall mortality is much lower in ehrlichiosis than in rickettsial disease but higher than in Lyme disease. The CDC reports a 1% to 3% mortality rate since 2000 in patients who present for medical care of ehrlichiosis. Anaplasmosis can be severe, with 36% of patients requiring hospitalization and 3% with life-threatening complications. Other reports have stated that up to 17% of hospitalized patients required admission to the intensive care unit. Many patients may be infected with ehrlichiosis but may not seek medical care, potentially leading to an overestimation of the mortality rate. Immunocompromised individuals, older adults, or those who have received pretreatment with sulfonamide antibiotics are predisposed to more severe illness.

• #3 Rickettsial Infections: Ehrlichia, Anaplasma, and Rocky Mountain Spotted Fever – Project Lyme

  https://projectlyme.org/resource/ehrlichia-anaplasma-and-rocky-mountain-spotted-fever/

  Other symptoms that can accompany the infections are: Flu-like illness, Joint pain, Disorientation, Stomach aches, Nausea and vomiting, Weight loss, Respiratory distress, Low white blood cell count, Anemia, Increased liver enzymes, Kidney failure. […] Those who are most prone to severe illness and require hospitalizations from Ehrlichia, Anaplama, and RMSF include the elderly, immunocompromised individuals, and people who have experienced a delay in treatment, states the CDC.

• #4 Anaplasmosis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/tickborne-illnesses/anaplasmosis.html

  Symptoms typically begin within 14 days after the bite of an infected tick. […] Early Illness Symptoms (1-5 days after tick bite): Fever, chills, Rash, Severe headache, Muscle aches, Nausea, vomiting, diarrhea, loss of appetite. […] Late Illness Symptoms (6-14 days after tick bite): Respiratory failure, Bleeding problems, Organ failure, Death.

• #4 Ehrlichiosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441966/

  Patients with Ehrlichia infections, regardless of organism, typically present with nonspecific, flu-like symptoms such as fever, malaise, headache, body aches, and chills. Other findings may include gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and rash. Cough and respiratory symptoms are more common in adults compared to children. The central nervous system may also be involved, leading to symptoms such as a stiff neck and headache, along with cerebrospinal fluid analysis indicating meningitis and meningoencephalitis. […] In some patients who have more severe early symptoms or in those who have been left untreated, symptoms may progress to acute respiratory distress syndrome or sepsis or shock-like presentation with cardiovascular instability and coagulopathy. However, overall mortality is much lower in ehrlichiosis than in rickettsial disease but higher than in Lyme disease. The CDC reports a 1% to 3% mortality rate since 2000 in patients who present for medical care of ehrlichiosis. Anaplasmosis can be severe, with 36% of patients requiring hospitalization and 3% with life-threatening complications. Other reports have stated that up to 17% of hospitalized patients required admission to the intensive care unit. Many patients may be infected with ehrlichiosis but may not seek medical care, potentially leading to an overestimation of the mortality rate. Immunocompromised individuals, older adults, or those who have received pretreatment with sulfonamide antibiotics are predisposed to more severe illness.

• #4 Anaplasmosis | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/anaplasmosis

  Treatment should be started immediately whenever anaplasmosis is suspected. In some cases, treatment is started based on clinical symptoms before the diagnosis is confirmed by lab testing. […] Antibiotic medicine is the main treatment. Doxycycline is an antibiotic that is given most often to work against the bacteria. If you have early treatment and have only mild symptoms, you can probably take your antibiotic at home. Your fever will likely go away in a few days. Your other symptoms may not go away for a few weeks. Once gone, these symptoms dont come back. […] In rare cases, anaplasmosis can cause serious complications such as: Brain problems such as confusion, seizures, or coma, Excess bleeding (hemorrhage), Heart failure, Breathing (respiratory) failure, Kidney failure, Septic shock. […] You may have a higher risk in the spring and summer in certain parts of the country. […] You may have no symptoms, mild symptoms, or severe symptoms. Some possible complications can be life-threatening.

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