Ehrlichiosis natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Ehrlichiosis}} | {{Ehrlichiosis}} | ||
===Complications | ==Natural History== | ||
Infection varies according to the Ehrlichiae agent responsible for the infection. Listed below are the progressive pathways of each infection: | |||
===HGE=== | |||
====Early Stage==== | |||
*Sudden onset of fever with rigors | |||
*Severe Myalgia | |||
*Early Symptoms such as pain, nausea, vomiting, weight loss, cough, and confusion | |||
====Late Stage==== | |||
*Toxic-like Syndrome | |||
*ARDS | |||
*Neurological disorders | |||
*Liver complications | |||
====If left untreated==== | |||
*Usually achieve a full recovery in 2 months | |||
*Immuno-compromised individuals may suffer severe infections or even death as a result of an opportunistic co-infection. | |||
===HME=== | |||
====Early Stage==== | |||
*Incubation of 7-10 days | |||
*Initial presenting symptoms include fever, headache, and malaise. | |||
*More severe infections will include myalgia, diaphoresis, weight loss, maculopapular rash, and confusion. | |||
====Late Stage==== | |||
*Progression of symptoms requires hospitalization | |||
*Majority of infected patients require intensive care | |||
*Even with medical therapy 2.7% of infected patients die | |||
====If left untreated==== | |||
*HME remains a life-threatening disease | |||
*Without proper treatment patients may suffer from hypotension, respiratory failure, acute renal failure, and hemorrhagic manifestations | |||
*Death | |||
==Complications== | |||
* [[Acute respiratory distress syndrome|Respiratory distress syndrome]] | * [[Acute respiratory distress syndrome|Respiratory distress syndrome]] | ||
* [[Hepatitis]] | * [[Hepatitis]] | ||
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* Opportunistic [[nosocomial infection]]s<ref>{{cite journal|last=Thomas|first=Rachael J|coauthors=Dumler, J Stephen, Carlyon, Jason A|title=Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and ehrlichiosis|journal=Expert Review of Anti-infective Therapy|date=1 August 2009|year=2009|month=August|volume=7|issue=6|pages=709–722|doi=10.1586/eri.09.44|pmid=19681699|pmc=2739015}}</ref> | * Opportunistic [[nosocomial infection]]s<ref>{{cite journal|last=Thomas|first=Rachael J|coauthors=Dumler, J Stephen, Carlyon, Jason A|title=Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and ehrlichiosis|journal=Expert Review of Anti-infective Therapy|date=1 August 2009|year=2009|month=August|volume=7|issue=6|pages=709–722|doi=10.1586/eri.09.44|pmid=19681699|pmc=2739015}}</ref> | ||
* [[Death]] | * [[Death]] | ||
==Prognosis== | |||
===HGE=== | |||
*The prognosis for HGE is usually good. | |||
*With proper treatment, patients should fully clear infection | |||
*About Half of infected individuals will require 6 days of hospitalization | |||
*Even in the absence of treatment, infected patients should clear infection within 2 months | |||
*Death associated with opportunistic co-infection. | |||
===HME=== | |||
*HME is a severe illness with many complications | |||
*Even in the presence of proper medical therapy, nearly 2.7% of infected patients will die | |||
*Infection must be closely monitored in order to reduce the amount of possible complications | |||
==References== | ==References== |
Revision as of 16:32, 18 January 2016
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Natural History
Infection varies according to the Ehrlichiae agent responsible for the infection. Listed below are the progressive pathways of each infection:
HGE
Early Stage
- Sudden onset of fever with rigors
- Severe Myalgia
- Early Symptoms such as pain, nausea, vomiting, weight loss, cough, and confusion
Late Stage
- Toxic-like Syndrome
- ARDS
- Neurological disorders
- Liver complications
If left untreated
- Usually achieve a full recovery in 2 months
- Immuno-compromised individuals may suffer severe infections or even death as a result of an opportunistic co-infection.
HME
Early Stage
- Incubation of 7-10 days
- Initial presenting symptoms include fever, headache, and malaise.
- More severe infections will include myalgia, diaphoresis, weight loss, maculopapular rash, and confusion.
Late Stage
- Progression of symptoms requires hospitalization
- Majority of infected patients require intensive care
- Even with medical therapy 2.7% of infected patients die
If left untreated
- HME remains a life-threatening disease
- Without proper treatment patients may suffer from hypotension, respiratory failure, acute renal failure, and hemorrhagic manifestations
- Death
Complications
- Respiratory distress syndrome
- Hepatitis
- Kidney damage
- Lung damage
- Other organ damage
- Seizure
- Candidiasis
- Opportunistic nosocomial infections[1]
- Death
Prognosis
HGE
- The prognosis for HGE is usually good.
- With proper treatment, patients should fully clear infection
- About Half of infected individuals will require 6 days of hospitalization
- Even in the absence of treatment, infected patients should clear infection within 2 months
- Death associated with opportunistic co-infection.
HME
- HME is a severe illness with many complications
- Even in the presence of proper medical therapy, nearly 2.7% of infected patients will die
- Infection must be closely monitored in order to reduce the amount of possible complications
References
- ↑ Thomas, Rachael J (1 August 2009). "Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and ehrlichiosis". Expert Review of Anti-infective Therapy. 7 (6): 709–722. doi:10.1586/eri.09.44. PMC 2739015. PMID 19681699. Unknown parameter
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