Ehrlichiosis ewingii infection

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Human ewingii ehrlichiosis
Specialty Infectious disease

Ehrlichiosis ewingii infection [1] is an infectious disease caused by an intracellular bacteria, Ehrlichia ewingii . [2] The infection is transmitted to humans by the tick, Amblyomma americanum . This tick can also transmit Ehrlichia chaffeensis , the bacteria that causes human monocytic ehrlichiosis (HME).

Contents

Signs and symptoms

Patients can present with fever, headache, myalgias, and malaise. Laboratory tests may reveal a low number of platelets in the blood, low levels of white blood cells in the bloodstream, and evidence of liver damage.[ citation needed ]

Mechanism

Humans contract the disease after a bite by an infected tick of the species Amblyomma americanum .[ citation needed ] Those with an underlying immunodeficiency (such as HIV) appear to be at greater risk of contracting the disease. Compared to HME, ewingii ehrlichiosis has a decreased incidence of complications. [3]

Like Anaplasma phagocytophilum , the causative agent of human granulocytic ehrlichiosis, Ehrlichia ewingii infects neutrophils. Infection with E. ewingii may delay neutrophil apoptosis. [4]

Diagnosis

In endemic areas, a high index of suspicion is warranted, especially with a known tick exposure. The diagnosis can be confirmed by using PCR. [5] A peripheral blood smear can also be examined for intracytoplasmic inclusions called morulae.[ citation needed ]

Treatment

The treatment of choice is doxycycline.[ citation needed ]

See also

References

  1. ↑ Rapini, Ronald P., Bolognia, Jean L., Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1130. ISBN   978-1-4160-2999-1.
  2. ↑ Patnaik MM (June 2009). "Inclusion bodies in tick-borne diseases diagnosed in patients from northern Wisconsin". Clin Med Res. 7 (1–2): 45–7. doi:10.3121/cmr.2009.807.818. PMC   2705270 . PMID   19574488.
  3. ↑ Paddock CD, Folk SM, Shore GM, et al. (November 2001). "Infections with Ehrlichia chaffeensis and Ehrlichia ewingii in persons coinfected with human immunodeficiency virus". Clinical Infectious Diseases. 33 (9): 1586–94. doi: 10.1086/323981 . PMID   11568857.
  4. ↑ Xiong Q, Bao W, Ge Y, Rikihisa Y (April 2008). "Ehrlichia ewingii infection delays spontaneous neutrophil apoptosis through stabilization of mitochondria". The Journal of Infectious Diseases. 197 (8): 1110–8. doi: 10.1086/533457 . PMID   18462160.
  5. ↑ Gusa, Aa, Buller, Rs, Storch, Ga, Huycke, Mm, MacHado, Lj, Slater, Ln, Stockham, Sl, Massung, Rf (Nov 2001). "Identification of a p28 gene in Ehrlichia ewingii: evaluation of gene for use as a target for a species-specific PCR diagnostic assay". Journal of Clinical Microbiology. 39 (11): 3871–6. doi:10.1128/JCM.39.11.3871-3876.2001. PMC   88457 . PMID   11682500.
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