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Ehrlichiosis and Anaplasmosis, Pediatric

Camille Sabella, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Two clinically described, tick-borne infections are human monocytic ehrlichiosis (HME), most commonly caused by Ehrlichia chaffeensis, and human granulocytic anaplasmosis (HGA), caus...

DIAGNOSIS

Classic presentation: fever, headache, and myalgias, followed by the development of a progressive leukopenia, thrombocytopenia, and anemia 

HISTORY

  • History of tick bite or exposure to wooded a...

TREATMENT

GENERAL MEASURES

  • Volume and blood pressure medications as needed

  • Intubation for respiratory failure

  • Dialysis for renal failure

  • Platelets for thrombocytopenia

  • Packed red blood cells for anemia

  • Fres...

ONGOING CARE

PROGNOSIS

  • >60% of patients are hospitalized.

  • Case fatality rate for HME is 1–3%; for HGA, <1%

  • Elevated BUN and creatinine have been associated with a more severe course.

  • Children appear...

ADDITIONAL READING

  • Dhand A, Nadelman RB, Aguero-Rosenfeld M, et al. Human granulocytic anaplasmosis during pregnancy: case series and literature review. Clin Infect Dis.  2007;45(5):589–593. [Vie...

CODES

ICD9

  • 082.40 Ehrlichiosis, unspecified

  • 082.41 Ehrlichiosis chafeensis [E. chafeensis]

  • 082.49 Other ehrlichiosis

ICD10

  • A77.40 Ehrlichiosis, unspecified

  • A77.41 Ehrlichiosis chafeensis [E. chafeensis]

  • A77....

FAQ

  • Q: If a tick is removed from my child, should antibiotics be started?

  • A: No. Antibiotics should be started if a child becomes symptomatic. Prophylactic use of antimicrobial agents does not prevent ...

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