Ehrlichiosis natural history, complications and prognosis
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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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