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Ehrlichiosis, Emergency Medicine

Roger M. Barkin and Jonathan A. Edlow Reviewed 06/2017
 


Basics

Description

  • Tick-borne human infection presenting as a nonspecific febrile illness

  • Several forms of ehrlichiosis exist; 2 predominate in North America

    • Human monocytic ehrlichiosis (HME), 1st descr...

Diagnosis

Signs and Symptoms

  • Signs and symptoms of HME and HGE/HGA are similar.

  • Many patients who are infected undergo asymptomatic seroconversion.

  • The spectrum reported may overrepresent the more severe...

Treatment

Initial Stabilization/Therapy

ABCs 

Ed Treatment/Procedures

  • Initiate antibiotics:

    • Doxycycline:

      • Drug of choice

      • Children who are affected should also receive doxycycline. 14 days of treatment does n...

Follow-Up

Disposition

Admission Criteria

  • Significant comorbidities/severely affected

  • Cannot take PO antibiotics

  • Immunosuppressed patients

  • E. chaffeensis (HME) has a case fatality rate up to 3%.

Discharge Criteria

Additional Reading

  • American Academy of Pediatrics. In: Pickering LK, Baker  CJ,Kimberlin  DW, et al., eds. Red Book: 2009 Report of the Committee onInfectious Diseases. 28th ed. Elk Grove, IL: AAP, 2...

Codes

ICD9

  • 082.40 Ehrlichiosis, unspecified

  • 082.41 Ehrlichiosis chafeensis [E. chafeensis]

  • 082.49 Other ehrlichiosis

  • 082.4 Ehrlichiosis

ICD10

  • A77.40 Ehrlichiosis, unspecified

  • A77.41 Ehrlichiosis chafeensis [...

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