Ehrlichiosis
Definition
Ehrlichiosis is a bacterial infection that is spread by ticks. Symptoms include fever, chills, headache, muscle aches, and tiredness.
Description
Ehrlichiosis is a tick-borne disease caused by infection with Ehrlichia bacteria. Ticks are small, blood-sucking arachnids. Although some ticks carry disease-causing organisms, most do not. When an animal or person is bitten by a tick that carries bacteria, the bacteria are passed to that person or animal during the tick's feeding process. It is believed that the tick must remain attached to the person or animal for at least 24 hours to spread the infection.
There are two forms of ehrlichiosis in the United States; human monocytic ehrlichiosis and human granulocytic ehrlichiosis. Monocytic ehrlichiosis is caused by Ehrlichia chaffeensis, which is spread by the Lone Star tick, Amblyomma americanum. As of early 1998, about 400 cases of monocytic ehrlichiosis had been reported in 30 states, primarily in the southeastern and south central United States. The bacteria that causes granulocytic ehrlichiosis is not known, but suspected to be either Ehrlichia equi or Ehrlichia phagocytophila. Granulocytic ehrlichiosis is probably spread by the blacklegged tick Ixodes scapularis (which also spreads Lyme disease). About 100 cases of granulocytic ehrlichiosis have been reported in Connecticut, Massachusetts, Rhode Island, Minnesota, New York, and Wisconsin.
Causes and symptoms
Both forms of ehrlichiosis have similar symptoms, and the illnesses can range from mild to severe and life-threatening. Risk factors include old age and exposure to ticks through work or recreation. Symptoms occur seven to 21 days following a tick bite although patients may not recall being bitten. Fever, tiredness, headache, muscle aches, chills, loss of appetite, confusion, nausea, and vomiting are common to both diseases. A rash may occur.
Diagnosis
Ehrlichiosis may be diagnosed and treated by doctors who specialize in blood diseases (hematologists) or an infectious disease specialist. Because ehrlichiosis is not very common and the symptoms are not unique, it may be misdiagnosed. A recent history of a tick bite is helpful in the diagnosis. Blood tests will be done to look for antibodies to Ehrlichia. Staining and microscopic examination of the blood sample may show Ehrlichia bacteria inside white blood cells. Another test, called polymerase chain reaction (PCR), is a very sensitive assay to detect bacteria in the blood sample, but it is not always available.
