Ehrlichia: confusing cousins, the blood supply, and the new kid on the block 05/04/2012
Posted by thetickthatbitme in Diagnosis, TBI Facts.Tags: Blood donation, Blood transfusion, CDC, Ehrlichia, health, Lyme Disease, medicine, Minnesota, Rocky Mountain Spotted Fever, tick, Wisconsin
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Ehrlichia…I just met a girl named Ehrlichia…and suddenly the sound…
Nope. Doesn’t quite work.
Paul Ehrlich (1854-1915). Image via Wikipedia.
Ehrlichia is actually named after German microbiologist Paul Ehrlich (1854-1915), who won the Nobel Prize in 1908. Here are some things you actually need to know about Ehrlichia:
1. Ehrlichia is transmitted through the bites of lonestar ticks and deer ticks. If you’ve had another infection carried by these ticks (like Lyme Disease), your doctor should have had you tested for Ehrlichia (or maybe you’ll be asking him/her to test you after reading this post?).
2. Symptoms of Ehrlichiosis include: fever, headache, chills, malaise, muscle pain, nausea / vomiting / diarrhea, confusion, conjunctival injection (red eyes), and rash (in up to 60% of children, less than 30% of adults). When it goes untreated (or improperly treated), complications can include breathing problems, bleeding disorders, and death (1.8% of cases).
3. Ehrlichia is effectively treated with doxycycline in both adults and children. The CDC recommends a 7-14 day course.
4. Your doctor shouldn’t wait for your test results to come back before prescribing you doxycycline. If your doctor thinks you might have Ehrlichiosis, he/she might order a PCR, a blood smear, or an IFA (antibody test). These tests can take a few weeks to come back, and in that time, you could get very, very sick. In addition, a negative result on any of these three tests does not rule out the possibility of infection. Often, in the first 7-10 days you are infected, you will test negative. For more information about these tests, take a look at the Ehrlichiosis fact sheet.
5. Ehrlichia can be easily misdiagnosed as one of two other infections. It’s a rickettisial disease, which means it’s in the same family with A. phagocytophilum and Rocky Mountain Spotted Fever (RMSF). Sometimes the rash patients get with Ehrlichia looks a lot like the rash patients get with RMSF.
6. It may be possible to contract an Ehrlichia infection through a blood transfusion. The CDC has not been very vocal about it, but it’s on their website. Fun fact: “Ehrlichia chaffeensis has been shown to survive for more than a week in refrigerated blood.” If you’ve had an Ehrlichia infection, it’s probably not a good idea for you to be a blood or organ donor.
7. There’s a newly identified species of Ehrlichia in Wisconsin and Minnesota. It doesn’t have a fancy species name yet, so scientists refer to it as Ehrlichia Wisconsin HM543746 or Ehrlichia muris-like (EML). This one is carried by deer ticks. If you live in one of these states and your doctor is not so hip to the new infectious disease research, he or she may have told you that you didn’t need to be tested for Ehrlichia because “we don’t have that here.” (I hate it when doctors say that!)Hopefully there will be a commercially-available, species-specific test for this soon. For now, my guess is that physicians in Wisconsin and Minnesota who suspect Ehrlichia infection are ordering tests for E. chaffeensis and E. ewingii.
Got an Ehrlichia story you’d like to share? Shoot me an e-mail.
THE TICK THAT BIT ME 
Love the blog…seriously….the colors, the subject…everything. I’m following you on twitter now. 🙂
Thanks 🙂 Your blog cracks me up on a daily basis. And I’m following you too.
I’m glad to know that I’m not the only one laughing! lol
I am currently sitting in the hospital with my 15 year old son who has that fancy new form of Ehrlichiosis. He is also a lung transplant and liver transplant patient, AND is currently going through chemotherapy. Ehrl is the last guy the kid needed to bump into!
Ehrl M-L is a big bully who seems to think people don’t need blood cells, so his white cells, neutrophils, platelets, hemoglobin, and red cells are all too low. His Potassium and Calcium levels are also decreased. His CRP (inflammation marker) is elevated. Thankfully his breathing and kidney & liver functions are fine so far.
My son has a disease (Langerhans Cell Histiocytosis) that affects 1 in 200,000 children. It destroyed his lungs by age 7, when over 90% of pulmonary LCH patients are adult smokers. Then came back in his new lungs (only one other case found). It figures he’d get the odd new strain of the odd tick disease. Lol.
I had ehrlichiosis in 2007. I coded before they figured out the culprit to high fever for weeks, liver inflamed, rash, white blood cell, and platelet issues. I had legionaries pneumonia along with the ehrlichiosis. No one can say if there are long term effects from the disease. Most people, even doctors, even infectious disease doctors, don’t know. Are there long term effects? Almost every year at the anniversary of this infection, I get something weird. Like, had to have my gall bladder out first year, shingles, etc.