Ehrlichiosis classification

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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

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.

Classification

• Ehrlichiosis is a broadly used medical term for multiple bacterial infections.
• Three Ehrlichia species have been identified in Human infections:

1. Ehrlichia Ewingii
2. Ehrlichia Chaffeensis
3. Ehrlichia Muris

• Infections with the above organism have similar or the same clinical presentation.
• Endemic Regions are different according to specific species.

Organism	Disease	Vector	Endemic Regions	Common Symptoms
Ehrlichia ewingii	Ehrlichiosis	Lonestar Tick	Southeastern and South Central United States	Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
Ehrlichia chaffeensis	Ehrlichiosis	Lonestar Tick	Southeastern and South Central United States	Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
Ehrlichia muris	Ehrlichiosis	Not yet established	Minnesota and Wisconsin	Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.

• There are two types of Ehrlichia infections, human monocytotropic ehrlichiosis(HME) 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.

Organism	Disease	Vector	Common Symptoms
Ehrlichia chaffeensis	Human Monocytotropic Ehrlichiosis	Lone Star Tick (Amblyomma americanum)	Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.
Anaplasma phagocytophilum	Human Granulocytotropic Anaplasmosis	Black-legged Tick (Ixodes scapularis)	Fever, headache, chills, malaise, muscle pain, nausea, confusion, red eyes, and rash (60% of children and 30% of adults.