Video:Human monocytotropic ehrlichiosis
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Description
Human monocytic ehrlichiosis caused by E. chaffeensis is known to spread through tick infection primarily in the southern, south-central and mid-Atlantic regions of the United States.[1] In recent years, the lone star tick has expanded its range along the East Coast to New England, putting more humans at risk for tick-borne infections.[2]Tetracycline antibiotics are the treatments of choice.[3]
Presentation
The most common symptoms are fever, headache, malaise, and muscle aches (myalgia). Compared to human granulocytic anaplasmosis, rash is more common.[4]
Complications
In terms of complications we find that they tend to be more frequent in immunocompromized(as opposed to immunocompetant individuals) and they are, ARDS, acute renal failure, multi organ failure, and secondary hemophagocytic lymphohistiocytosis.[5]
Cause
HME is caused by Ehrlichia chaffeensis, and is transmitted via tick vector Amblyomma americanum.[3]
Mechanism
E. chaffeensis causes human monocytic ehrlichiosis and is known to infect monocytes. It has also been known to infect other cell types such as lymphocytes, atypical lymphocytes, myelocytes, and neutrophils, but monocytes appear to best harbor the infection.[6][7]
Diagnosis
Ehrlichia serologies can be negative in the acute period. Polymerase chain reaction is therefore the laboratory diagnostic tool of choice.[8][3]
Differential diagnosis
In terms of the differential diagnosis we find the following, Human Granulocytic Ehrlichiosis , Sennetsu fever, Rocky Mountain spotted fever, Babesiosis ,Lyme Disease and Meningococcal disease.[3]
Treatment
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.[9]
Epidemiology
In the US, human monocytotropic ehrlichiosis 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.[10][11]
Research
In terms of the investigation of the bacterium, E. chaffeensis, we find it might be responsive to antibacterial drug rifampin, though obviously more research is needed to determine safety.[3][12]
References
- ↑ Barker, R. W. (2000). "Naturally occurring ehrlichia chaffeensis infection in coyotes from oklahoma". Emerging Infectious Diseases. 6 (5): 477–80. doi:10.3201/eid0605.000505. PMC 2627953. PMID 10998377.
- ↑ Little, S. E. (2007, January). New developments in managing vector-borne diseases. Retrieved from http://www.iknowledgenow.com/tocnavc2007smallanimal.cfm Archived 2012-01-12 at the Wayback Machine
- ↑ 3.0 3.1 3.2 3.3 3.4 "Human Monocytic Ehrlichiosis (HME) - Symptoms, Causes, Treatment | NORD". rarediseases.org. Retrieved 6 August 2024.
- ↑ Dumler JS, Choi KS, Garcia-Garcia JC, et al. (December 2005). "Human granulocytic anaplasmosis and Anaplasma phagocytophilum". Emerging Infectious Diseases. 11 (12): 1828–34. doi:10.3201/eid1112.050898. PMC 3367650. PMID 16485466.
- ↑ Gygax, Larissa; Schudel, Sophie; Kositz, Christian; Kuenzli, Esther; Neumayr, Andreas (2 August 2024). "Human monocytotropic ehrlichiosis—A systematic review and analysis of the literature". PLOS Neglected Tropical Diseases. 18 (8): e0012377. doi:10.1371/journal.pntd.0012377. ISSN 1935-2735. Retrieved 5 August 2024.
- ↑ Ganguly, S (2008). "Tick-borne ehrlichiosis infection in human beings" (PDF). Journal of Vector Borne Diseases. 45 (4): 273–280. Archived (PDF) from the original on 2021-08-04. Retrieved 2023-01-30.
- ↑ Y, Rikihisa (14 January 2022). "The "Biological Weapons" of Ehrlichia chaffeensis: Novel Molecules and Mechanisms to Subjugate Host Cells". Frontiers in cellular and infection microbiology. 11. doi:10.3389/fcimb.2021.830180. ISSN 2235-2988.
- ↑ Prince LK, Shah AA, Martinez LJ, Moran KA (August 2007). "Ehrlichiosis: making the diagnosis in the acute setting". Southern Medical Journal. 100 (8): 825–8. doi:10.1097/smj.0b013e31804aa1ad. PMID 17713310. S2CID 31487400.
- ↑ Hamburg BJ, Storch GA, Micek ST, Kollef MH (March 2008). "The importance of early treatment with doxycycline in human ehrlichiosis". Medicine. 87 (2): 53–60. doi:10.1097/MD.0b013e318168da1d. PMID 18344803. S2CID 2632346.
- ↑ Andrews, K. E.; Eversman, K. K.; Foré, S. A.; Kim, H. J. (2019). "Seasonality and trends in incidence of human ehrlichiosis in two Missouri ecoregions". Epidemiology and Infection. 147: e123. doi:10.1017/S0950268818003448. Archived from the original on 27 October 2021. Retrieved 21 January 2023.
- ↑ Rose, Stuart R.; Keystone, Jay S.; Connor, Bradley A.; Hackett, Peter; Kozarsky, Phyllis E.; Quarry, Doug (1 January 2006). "CHAPTER 9 - Insect-Borne Diseases". International Travel Health Guide 2006-2007 (Thirteenth Edition). Mosby. pp. 140–158. ISBN 978-0-323-04050-1. Archived from the original on 21 October 2021. Retrieved 22 January 2023.
- ↑ Abusaada, Khalid; Ajmal, Saira; Hughes, Laura (1 January 2016). "Successful Treatment of Human Monocytic Ehrlichiosis with Rifampin". Cureus. 8 (1): e444. doi:10.7759/cureus.444. ISSN 2168-8184. Archived from the original on 21 January 2022. Retrieved 21 January 2023.