Ehrlichia: Difference between revisions
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::* Preferred regimen: [[Doxycycline]] 2 mg/kg IV/PO q12h (max 200 mg/day) for 10 days | ::* Preferred regimen: [[Doxycycline]] 2 mg/kg IV/PO q12h (max 200 mg/day) for 10 days | ||
:* <8 years old without Lyme disease | :* <8 years old without Lyme disease | ||
::* Preferred regimen: | ::* Preferred regimen: [[Doxycycline]] 2 mg/kg IV/PO q12h (max 200 mg/day) for 4-5 days (or 3 days after resolution of fever) | ||
==See also== | ==See also== | ||
Revision as of 17:32, 26 June 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ehrlichia is a genus of rickettsiales bacteria. They are transmitted by ticks. Several species can cause infection (Ehrlichiosis) in humans. The genus is named after German microbiologist Paul Ehrlich. These diseases are considered zoonotic as the main reservoir for the pathogen is in animal, usually mammal species.
Ehrlichia are obligately intracellular pathogens and are transported between cells through the host cell filopodia during initial stages of infection, whereas, in the final stages of infection the pathogen ruptures the host cell membrane.[2]
A new species of Ehrlichia has been discovered inside the deer tick Ixodes scapularis. This newly found organism has only been isolated from deer ticks in Wisconsin and Minnesota in the USA. The species is known as Ehrlichia Wisconsin HM543746.
History
The first ehrlichial disease was first recognized in South Africa during the 19th century. Its tick-borne nature was determined in 1900. The organism itself was demonstrated 1925 when it was recognized to be a rickettsia. It was initially named Rickettsia ruminantium, and is currently named Ehrlichia ruminantium. In 1945 a "infection and treatment" method for livestock was developed. This is still the only commercially available "vaccine" against the disease, which is not a true vaccine, but intentional exposure to the disease with monitoring and antibiotic treatment if needed. In 1985 the organism was first propagated reliably in tissue culture.
Treatment
Antimicrobial regimen
- Preferred regimen: Doxycycline 100 mg PO/IV q12h for 7-14 days
- NOTE: Patients should be treated for at least 3 days after the fever subsides and until there is evidence of clinical improvement
- Alternative regimen: Chloramphenicol 500mg QID OR Rifampin 600 mg PO/IV daily for 7-10 days
- Human Monocytic Ehrlichiosis or Human Granulocytic Anaplasmosis (pediatric)
- ≥8 years old
- Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (max 200 mg/day) for 10 days
- <8 years old without Lyme disease
- Preferred regimen: Doxycycline 2 mg/kg IV/PO q12h (max 200 mg/day) for 4-5 days (or 3 days after resolution of fever)
See also
- Cowdria ruminantium (Ehrlichia ruminantium)
- Ehrlichiosis (canine)
- Human granulocytic ehrlichiosis (now called Human granulocytic anaplasmosis)
- Human monocytic ehrlichiosis
References
- ↑ Garrity, George (2005). Bergey's Manual of Systematic Bacteriology. Springer. ISBN 0-387-24145-0.
- ↑ Thomas S, Popov VL, Walker DH (2010) Exit Mechanisms of the Intracellular Bacterium Ehrlichia. PLoS ONE 5(12): e15775. http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0015775
External links
- Ehrlichia genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID
- Ehrlichia at the US National Library of Medicine Medical Subject Headings (MeSH)
- Forum discution and clinical presentation (RO) Clinical experiences about ehrlichia and coinfections at dogs in Romania
- [2] Newly discovered species of Ehrlichia found in deer ticks