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==Overview==
==Overview==
Three strains of Ehrlichia (E. ewingii, E. chaffeensis, and E. Muris) are responsible for human infection. These resulting infections present themselves with very similar, if not the same, clinical manifestations. Endemic regions are different among the different diseases which may be used to diagnose the organism of infection.<ref name="E Sym">Ehrlichiosis Symptoms. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/ehrlichiosis/symptoms/index.html Accessed on December 30, 2015</ref>
Four species (''E. ewingii, E. chaffeensis, E. Muris'', and ''A. phagocytophilum'') are responsible for human ehrlichiosis infections. ehrlichiosis infections present themselves with very similar, if not the same, clinical manifestations. Differences may be highlighted in the heightened fatality rate and neurological based clinical manifestations of HME versus other types of ehrlichiosis.  Endemic regions are different among the different diseases which may be used to diagnose the organism of infection.<ref name="E Sym">Ehrlichiosis Symptoms. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/ehrlichiosis/symptoms/index.html Accessed on December 30, 2015</ref>


==Classification==
==Classification==
* Ehrlichiosis is a broadly used medical term for multiple bacterial infections.  
* Ehrlichiosis is a broadly used medical term for multiple bacterial infections.  
* Three ''Ehrlichia'' species have been identified in Human infections:  
* Four species have been identified in human ehrlichiosis infections (each disease is associated with a specific bacterial strain):  
# ''Ehrlichia Ewingii''
# ''Ehrlichia ewingii''
# ''Ehrlichia Chaffeensis''
# ''Ehrlichia chaffeensis''
# ''Ehrlichia Muris''
# ''Ehrlichia muris''<ref name="“HML">Human Infection with Ehrlichia muris–like Pathogen, United States, 2007–2013.  Diep K. Hoang Johnson2, Elizabeth Schiffman2, Jeffrey P. Davis, David Neitzel, Lynne M. Sloan, William L. Nicholson, Thomas R. Fritsche, Christopher R. Steward, Julie A. Ray, Tracy K. Miller, Michelle A. Feist, Timothy S. Uphoff, Joni J. Franson, Amy L. Livermore, Alecia K. Deedon, Elitza S. Theel, and Bobbi S. Prit. http://wwwnc.cdc.gov/eid/article/21/10/15-0143_article Accessed January 13, 2016. </ref>
* Infections with the above organism have similar or the same clinical presentation.
# ''Anaplasma phagocytophilum''
* Endemic Regions are different according to specific species.<ref name="E Sym">Ehrlichiosis Symptoms. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/ehrlichiosis/symptoms/index.html Accessed on December 30, 2015</ref>
*Infections with the above organism have similar or the same clinical presentation.
*HME however has proven to be more fatal than other Ehrlichia infections, including CNS and neurological disorders inflicting nearly 20% of all infected patients.


{| style="font-size: 85%;"
{| style="font-size: 85%;"
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|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ehrlichia ewingii]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ehrlichia ewingii]]''
| style="background: #DCDCDC; padding: 5px;" |Ehrlichiosis
| style="background: #DCDCDC; padding: 5px;" |Human ehrlichiosis ewingii (HEE)
| style="background: #DCDCDC; padding: 5px;" |Lonestar Tick
| style="background: #DCDCDC; padding: 5px;" |Lone Star Tick (''Amblyomma americanum'')
| style="background: #DCDCDC; padding: 5px;" |Southeastern and South Central United States
| style="background: #DCDCDC; padding: 5px;" |Southeastern and South Central United States
| style="background: #DCDCDC; padding: 5px;" |Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
| style="background: #DCDCDC; padding: 5px;" | Similar symptoms to those of HME and HGA. Although not much has been documented due to the minor amount of reported cases.  
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ehrlichia chaffeensis]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ehrlichia chaffeensis]]''
| style="background: #DCDCDC; padding: 5px;" |Ehrlichiosis
| style="background: #DCDCDC; padding: 5px;" |Human Monocytotropic Ehrlichiosis
| style="background: #DCDCDC; padding: 5px;" |Lonestar Tick
| style="background: #DCDCDC; padding: 5px;" |Lone Star Tick (''Amblyomma americanum'')
| style="background: #DCDCDC; padding: 5px;" |Southeastern and South Central United States
| style="background: #DCDCDC; padding: 5px;" |Mississippi, Tennessee, Arkansas, and Maryland. South central and Southeastern United States.
| style="background: #DCDCDC; padding: 5px;" |Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
| style="background: #DCDCDC; padding: 5px;" |More Severe than HGA and HEE. Clinical manifestations include gastrointestinal symptoms, headaches, myalgias, and arthralgias. It's been documented that 20% of infected patients have neurological manifestations, CNS complications, potential seizures and coma. Potential rash, however the rash may indicate a co-infection between [[Rocky Mountain Spotted Fever]] and Ehrlichiosis.  
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ehrlichia canis|Ehrlichia muris]]''  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ehrlichia canis|Ehrlichia muris]]''  
| style="background: #DCDCDC; padding: 5px;" |Ehrlichiosis  
| style="background: #DCDCDC; padding: 5px;" |Ehrlichiosis muris-like (EML)
| style="background: #DCDCDC; padding: 5px;" | Not yet established
| style="background: #DCDCDC; padding: 5px;" | Not yet established
| style="background: #DCDCDC; padding: 5px;" |Minnesota and Wisconsin
| style="background: #DCDCDC; padding: 5px;" |Minnesota and Wisconsin
| style="background: #DCDCDC; padding: 5px;" |Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
| style="background: #DCDCDC; padding: 5px;" |Common symptoms include fever, malaise, thrombocytopenia, and lymphopenia.
|}<ref name="E Sym">Ehrlichiosis Symptoms. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/ehrlichiosis/symptoms/index.html Accessed on December 30, 2015</ref>
 
*There are two types of ''Ehrlichia'' infections, human monocytotropic ehrlichiosis (HME), human ehrlichiosis ewingii (HEE),  and human granulocytotropic anaplasmosis (HGA), previously referred to as human granulocytotropic ehrlichiosis (HGE).
*HME is primarily transmitted by the Lone Star Tick (''Amblyomma Americanum'').
*HGA is caused by ''phagocytophilum''.
*Clinical presentation is similar between HME and HGA, with symptoms such as fever, headache, and leukopenia.
 
{| style="font-size: 85%;"
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Organism}}
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Disease}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Vector}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Common Symptoms}}
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ehrlichia chaffeensis]]''
| style="background: #DCDCDC; padding: 5px;" |Human Monocytotropic Ehrlichiosis
| style="background: #DCDCDC; padding: 5px;" |Lone Star Tick (''Amblyomma americanum'')
| style="background: #DCDCDC; padding: 5px;" |Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Anaplasma phagocytophilum]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Anaplasma phagocytophilum]]''
| style="background: #DCDCDC; padding: 5px;" |Human Granulocytotropic Anaplasmosis  
| style="background: #DCDCDC; padding: 5px;" |Human Granulocytotropic Anaplasmosis  
| style="background: #DCDCDC; padding: 5px;" |Black-legged Tick (''Ixodes scapularis'')
| style="background: #DCDCDC; padding: 5px;" |Black-legged Tick (''Ixodes scapularis'')
| style="background: #DCDCDC; padding: 5px;" |Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
| style="background: #DCDCDC; padding: 5px;" |Occurs worldwide (including portions of Europe and Asia.)
|}
| style="background: #DCDCDC; padding: 5px;" |Fever, headache, and myalgias. Rash is uncommon, and CNS disorders as well as neurological issues have been reported in less than 1%.
|}<ref name="E Sym">Ehrlichiosis Symptoms. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/ehrlichiosis/symptoms/index.html Accessed on December 30, 2015</ref><ref name="“HEA">Human Ehrlichiosis and Anaplasmosis. Ismail N, Bloch KC, Mcbride JW. Human ehrlichiosis and anaplasmosis. Clin Lab Med. 2010;30(1):261-92. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882064/ Accessed January 13, 2016. </ref><ref name="“HML">Human Infection with Ehrlichia muris–like Pathogen, United States, 2007–2013.  Diep K. Hoang Johnson2, Elizabeth Schiffman2, Jeffrey P. Davis, David Neitzel, Lynne M. Sloan, William L. Nicholson, Thomas R. Fritsche, Christopher R. Steward, Julie A. Ray, Tracy K. Miller, Michelle A. Feist, Timothy S. Uphoff, Joni J. Franson, Amy L. Livermore, Alecia K. Deedon, Elitza S. Theel, and Bobbi S. Prit. http://wwwnc.cdc.gov/eid/article/21/10/15-0143_article Accessed January 13, 2016.</ref>


==References==
==References==
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]

Latest revision as of 17:38, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.

Overview

Four species (E. ewingii, E. chaffeensis, E. Muris, and A. phagocytophilum) are responsible for human ehrlichiosis infections. ehrlichiosis infections present themselves with very similar, if not the same, clinical manifestations. Differences may be highlighted in the heightened fatality rate and neurological based clinical manifestations of HME versus other types of ehrlichiosis. Endemic regions are different among the different diseases which may be used to diagnose the organism of infection.[1]

Classification

  • Ehrlichiosis is a broadly used medical term for multiple bacterial infections.
  • Four species have been identified in human ehrlichiosis infections (each disease is associated with a specific bacterial strain):
  1. Ehrlichia ewingii
  2. Ehrlichia chaffeensis
  3. Ehrlichia muris[2]
  4. Anaplasma phagocytophilum
  • Infections with the above organism have similar or the same clinical presentation.
  • HME however has proven to be more fatal than other Ehrlichia infections, including CNS and neurological disorders inflicting nearly 20% of all infected patients.
Organism Disease Vector Endemic Regions Common Symptoms
Ehrlichia ewingii Human ehrlichiosis ewingii (HEE) Lone Star Tick (Amblyomma americanum) Southeastern and South Central United States Similar symptoms to those of HME and HGA. Although not much has been documented due to the minor amount of reported cases.
Ehrlichia chaffeensis Human Monocytotropic Ehrlichiosis Lone Star Tick (Amblyomma americanum) Mississippi, Tennessee, Arkansas, and Maryland. South central and Southeastern United States. More Severe than HGA and HEE. Clinical manifestations include gastrointestinal symptoms, headaches, myalgias, and arthralgias. It's been documented that 20% of infected patients have neurological manifestations, CNS complications, potential seizures and coma. Potential rash, however the rash may indicate a co-infection between Rocky Mountain Spotted Fever and Ehrlichiosis.
Ehrlichia muris Ehrlichiosis muris-like (EML) Not yet established Minnesota and Wisconsin Common symptoms include fever, malaise, thrombocytopenia, and lymphopenia.
Anaplasma phagocytophilum Human Granulocytotropic Anaplasmosis Black-legged Tick (Ixodes scapularis) Occurs worldwide (including portions of Europe and Asia.) Fever, headache, and myalgias. Rash is uncommon, and CNS disorders as well as neurological issues have been reported in less than 1%.

[1][3][2]

References

  1. ↑ 1.0 1.1 Ehrlichiosis Symptoms. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/ehrlichiosis/symptoms/index.html Accessed on December 30, 2015
  2. ↑ 2.0 2.1 Human Infection with Ehrlichia muris–like Pathogen, United States, 2007–2013. Diep K. Hoang Johnson2, Elizabeth Schiffman2, Jeffrey P. Davis, David Neitzel, Lynne M. Sloan, William L. Nicholson, Thomas R. Fritsche, Christopher R. Steward, Julie A. Ray, Tracy K. Miller, Michelle A. Feist, Timothy S. Uphoff, Joni J. Franson, Amy L. Livermore, Alecia K. Deedon, Elitza S. Theel, and Bobbi S. Prit. http://wwwnc.cdc.gov/eid/article/21/10/15-0143_article Accessed January 13, 2016.
  3. ↑ Human Ehrlichiosis and Anaplasmosis. Ismail N, Bloch KC, Mcbride JW. Human ehrlichiosis and anaplasmosis. Clin Lab Med. 2010;30(1):261-92. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882064/ Accessed January 13, 2016.
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