Ehrlichiosis

Medically reviewed by Alana Biggers, MD on July 26, 2017Written by Ana Gotter

Tick bites

Tick bites are known to cause Lyme disease, but they can also transmit a condition called ehrlichiosis.

Ehrlichiosis is a bacterial illness that causes flu-like symptoms that include fever and aches. It can cause very serious complications if left untreated. But it can be cured with prompt treatment.

Ehrlichiosis is most frequently caused by a bite from an infected lone star tick, though it can also be transmitted by dog ticks or deer ticks. Lone star ticks are common throughout the southeastern and south central United States, as well as the East Coast. The females have a white spot on their back.

Pictures of ehrlichiosis

What are the symptoms of ehrlichiosis?

Many people with ehrlichiosis think they have the flu or the stomach flu. The most common symptoms are:

  • chills
  • fever
  • muscle aches
  • headaches
  • general malaise
  • nausea
  • diarrhea

Only a small portion of people with ehrlichiosis will experience any type of rash. There are two types of rashes that can occur with this condition:

  • petechial rashes, which are tiny pin-sized spots caused by bleeding under the skin
  • flat, red rashes

The symptoms of ehrlichiosis are similar to the Rocky Mountain Spotted Fever, another tick-borne illness. However, Rocky Mountain Spotted Fever is more likely to cause a rash.

Symptoms typically begin between 7 and 14 days after the tick bite, though some people never realize they have been bit by a tick.

If you see the tick:

Remove it carefully and very slowly, making sure to grab it as close to the head as possible so that no part of it gets left within your body. Kill it by placing it in rubbing alcohol. Never crush it and avoid touching it even with your fingers, as this alone can spread bacterial infections. You can tape it to a notecard so your doctor can test it later if needed.

What’s the difference between ehrlichiosis and anaplasmosis?

The lone star tick can also cause another infection called anaplasmosis. The symptoms of anaplasmosis are very similar to ehrlichiosis. The main difference between the two infections is that ehrlichiosis is caused by E. chaffeensis bacteria. Anaplasmosis is caused by Anaplasma phagocytophilum bacteria.

How is ehrlichiosis diagnosed?

If you’ve been bitten by a tick and are experiencing flu-like symptoms or notice a rash, make an appointment to see your doctor right away. Your doctor can test you for ehrlichiosis and other dangerous conditions caused by ticks, such as Lyme disease.

Your doctor will inspect the site of the tick bite and ask about what symptoms you’re experiencing. They will take your blood pressure and order blood tests to check for signs of a bacterial infection. These signs may include a low white blood cell count and a low platelet count, along with the presence of certain antibodies.

The blood work can also evaluate your kidney and liver function to search for complications.

Can ehrlichiosis cause other conditions to develop?

Even in a very healthy person (both adults and children), ehrlichiosis can have very serious consequences if left untreated. The risk of these complications increases significantly in those with weakened immune systems.

These complications can include:

  • organ failure, including kidney and liver failure
  • respiratory failure
  • heart failure
  • falling into a coma
  • seizures

While many of these complications can be treated if caught early enough, they may not be reversible. Though it’s extremely uncommon, people can die from ehrlichiosis.

How is ehrlichiosis treated?

Your doctor may prescribe medication before they even get the test results if they suspect ehrlichiosis.

Treatment will involve taking an antibiotic for 10 to 14 days. Doxycycline (Acticlate) is the most commonly prescribed antibiotic for ehrlichiosis. However, your doctor may prescribe another antibiotic like rifampin (Rifadin) if you’re pregnant.

What is the outlook for ehrlichiosis?

Prompt treatment of ehrlichiosis is essential because severe complications can occur if it’s left untreated. Most people will be fully treated with a round of antibiotics. You should start to see significant improvement within 24 to 48 hours after starting treatment. Most people will experience a full recovery within three weeks of treatment.

Your best bet is to avoid ehrlichiosis and tick bites altogether. If you know you’ll be in an area that has ticks, practice tick-prevention methods to keep them away from you and your family.

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