Human monocytotropic ehrlichiosis

The most common symptoms are fever, headache, malaise, and muscle aches (myalgia). Compared to human granulocytic ehrlichiosis, rash is more common.[3] Laboratory abnormalities include thrombocytopenia, leukopenia, and elevated liver tests.

The severity of the illness can range from minor or asymptomatic to life-threatening. CNS involvement may occur. A serious septic or toxic shock-like picture can also develop, especially in patients with impaired immunity.[4]

This disease is known to be caused by tick bites.

Tick exposure is often overlooked. For patients living in high-prevalence areas who spend time outdoors, a high degree of clinical suspicion should be employed.

Ehrlichia serologies can be negative in the acute period. PCR is therefore the laboratory diagnostic tool of choice.[5]

If ehrlichiosis is suspected, treatment should not be delayed while waiting for a definitive laboratory confirmation, as prompt doxycycline therapy has been associated with improved outcomes.[6] Doxycycline is the treatment of choice.

Presentation during early pregnancy can complicate treatment.[7]Rifampin has been used in pregnancy and in patients allergic to doxycycline.[8]

In the USA, HME occurs across the south-central, southeastern, and mid-Atlantic states, regions where both the white-tailed deer (Odocoileus virginianus) and lone star ticks (Amblyomma americanum) thrive.

HME occurs in California in Ixodes pacificus ticks and in Dermacentor variabilis ticks.[9]Nearly 600 cases were reported to the CDC in 2006. In 2001–2002, the incidence was highest in Missouri, Tennessee, and Oklahoma, as well as in people older than 60.[10]

• Human ewingii ehrlichiosis
• Human granulocytic anaplasmosis
• Monocyte