Medicine:Ehrlichiosis ewingii infection

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Human ewingii ehrlichiosis
SpecialtyInfectious 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).

Signs and symptoms

Mechanism

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.

Treatment

Doxycycline is the treatment of choice for suspected Ehrlichia ewingii infection in adults and children of all ages, and treatment should be started as soon as ehrlichiosis is suspected rather than delayed pending laboratory confirmation.[6]

See also

References

  1. ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 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. PMID 19574488. 
  3. ↑ "Infections with Ehrlichia chaffeensis and Ehrlichia ewingii in persons coinfected with human immunodeficiency virus". Clinical Infectious Diseases 33 (9): 1586–94. November 2001. doi:10.1086/323981. PMID 11568857. 
  4. ↑ "Ehrlichia ewingii infection delays spontaneous neutrophil apoptosis through stabilization of mitochondria". The Journal of Infectious Diseases 197 (8): 1110–8. April 2008. 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. PMID 11682500. 
  6. ↑ Biggs, Holly M.; Behravesh, Casey Barton; Bradley, Kristy K.; Dahlgren, F. Scott; Drexler, Nausheen A.; Dumler, J. Stephen; Folk, Sarah M.; Kato, Carol Y. et al. (2016). "Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States". MMWR Recommendations and Reports 65 (2): 1–44. doi:10.15585/mmwr.rr6502a1. PMID 27172113. 
Classification
External resources

Template:Bacterial cutaneous infections



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