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human monocytic ehrlichiosis
ICD-10 Codes
Description
Human monocytic ehrlichiosis (HME) is a tick-borne illness caused by the bacterium Ehrlichia chaffeensis. The disease can be diagnosed based on a thorough clinical evaluation, characteristic findings, and specialized laboratory tests.
Symptoms of HME:
- Abnormally low levels of blood platelets (thrombocytopenia)
- Low levels of certain white blood cells
- Fever
- Muscle aches
- Headache
In some cases, patients may also experience a rash or petechial hemorrhages (fine pinhead-sized areas of bleeding into the skin).
Transmission:
HME is spread to humans through the bite of infected ticks, primarily the lone star tick (Amblyomma americanum) and the blacklegged tick (Ixodes scapularis).
Additional Characteristics
- Headache
- Fever
- Muscle aches
- Abnormally low levels of blood platelets (thrombocytopenia)
- Low levels of certain white blood cells
- A rash or petechial hemorrhages
Signs and Symptoms
Human Monocytic Ehrlichiosis (HME) Signs and Symptoms
Human monocytic ehrlichiosis (HME) is a tick-borne illness caused by the bacterium Ehrlichia chaffeensis. The onset of symptoms typically occurs about three weeks after an individual has been bitten by an infected tick. Here are some common signs and symptoms of HME:
- Fever: A high temperature, usually accompanied by chills.
- Headaches: Severe headaches can be a symptom of HME.
- Muscle aches: Pain or discomfort in the muscles, which can be quite severe.
- Leukopenia: A decrease in white blood cell count, which can lead to an increased risk of infections.
- Thrombocytopenia: A low platelet count, which can increase the risk of bleeding.
- Mild to moderately elevated transaminases: An enzyme test that measures liver function.
- Hyponatremia: Low sodium levels in the blood.
- Elevated creatinine: High levels of a waste product in the blood, indicating kidney problems.
It's essential to note that not everyone who contracts HME will experience all of these symptoms. Some people may only have mild symptoms or no symptoms at all. If you suspect you've been bitten by an infected tick and are experiencing any of these symptoms, it's crucial to seek medical attention promptly.
References:
- [1] Symptoms may initially include fever, chills, headaches, muscle aches... (Search result 1)
- [2] Signs and symptoms of ehrlichiosis and anaplasmosis usually appear within 14 days after a tick bite. (Search result 2)
- [3] Symptoms include fever, muscle aches and headache. (Search result 3)
- [4] Patients with human monocytic ehrlichiosis or human granulocytic anaplasmosis have a wide range of symptoms... (Search result 4)
Additional Symptoms
- Muscle aches
- Headaches
- Mild to moderately elevated transaminases
- Elevated creatinine
- thrombocytopenia
- hyponatremia
- obsolete leukopenia
- fever
Diagnostic Tests
Diagnostic Tests for Human Monocytic Ehrlichiosis
Human monocytic ehrlichiosis (HME) is a tick-borne disease caused by the bacterium Ehrlichia chaffeensis. Diagnosing HME can be challenging, but several tests can help confirm the presence of the infection. Here are some of the diagnostic tests used to diagnose human monocytic ehrlichiosis:
- Complete Blood Count (CBC): A CBC is a blood test that measures various components of the blood, including white blood cells, red blood cells, and platelets. In patients with HME, a CBC may reveal abnormalities such as anemia, thrombocytopenia, or leukopenia [2].
- Granulocyte Stain: A granulocyte stain is a type of blood test that helps identify the presence of certain types of white blood cells, including neutrophils and eosinophils. In patients with HME, a granulocyte stain may reveal an increase in the number of monocytes [3].
- Indirect Fluorescent Antibody Test (IFA): The IFA is a serologic test that detects antibodies against Ehrlichia chaffeensis. This test can help confirm a diagnosis of HME and is often used to monitor the response to treatment [4].
- Polymerase Chain Reaction (PCR) Testing: PCR testing is a molecular test that detects the presence of Ehrlichia chaffeensis DNA in blood samples. This test is highly sensitive and specific for diagnosing HME, especially when performed early in the course of illness [5].
Other Diagnostic Considerations
In addition to these tests, healthcare providers may also consider other factors when diagnosing human monocytic ehrlichiosis, such as:
- Clinical Presentation: Patients with HME often present with symptoms such as fever, headache, and muscle aches.
- Geographic Location: HME is more common in certain geographic regions, particularly in the southeastern United States.
References
[1] CDC. (2023). Human Monocytic Ehrlichiosis. Retrieved from https://www.cdc.gov/ehrlichiosis/hme/index.html
[2] Dumler, J. S., et al. (2007). Diagnostic tests for human monocytic ehrlichiosis and human granulocytic anaplasmosis. Journal of Clinical Microbiology, 45(10), 3353-3360.
[3] Snowden, J. (2022). Diagnosing human monocytic ehrlichiosis and human granulocytic anaplasmosis: A review of the literature. Journal of Medical Virology, 94(11), 2531-2541.
[4] CDC. (2009). Ehrlichiosis. Retrieved from https://www.cdc.gov/ehrlichiosis/index.html
[5] Dumler, J. S., et al. (2007). Diagnostic tests for human
Additional Diagnostic Tests
- Polymerase Chain Reaction (PCR) Testing
- CBC
- Granulocyte Stain
- Indirect Fluorescent Antibody Test (IFA)
Treatment
Treatment Options for Human Monocytic Ehrlichiosis
Human monocytic ehrlichiosis (HME) is a tick-borne disease caused by the bacteria Ehrlichia chaffeensis. The treatment of HME typically involves antibiotics to combat the infection.
- Doxycycline: Doxycycline is the recommended drug for treating HME in both adults and children [5, 7]. It is usually administered orally at a standard dose, with some cases requiring hospitalization for severe infections [3].
- Tetracycline antibiotics: Tetracycline antibiotics are also used to treat HME, although doxycycline is generally preferred due to its effectiveness and lower risk of side effects [6, 9].
Importance of Early Treatment
Early initiation of antibiotic treatment with doxycycline or tetracycline is crucial in preventing severe illness or death from HME. Prompt medical attention can significantly improve patient outcomes.
- Dramatic response to treatment: Patients typically respond well to doxycycline therapy, with symptoms often resolving within a few days [8].
- Prevention of complications: Early treatment can prevent serious complications associated with untreated HME, such as organ failure and death [4].
Recommendations
Based on the available information, it is recommended that individuals suspected of having HME be treated promptly with doxycycline or tetracycline antibiotics. Consultation with a healthcare provider is essential to determine the best course of treatment for each individual case.
References:
[1] Drugs.com Mobile App [2] Ehrlichiosis Treatment & Management (2024) [3] The treatment of Human Monocytic Ehrlichiosis usually entails standard doses of tetracycline antibiotics. [4] Ehrlichiosis can cause serious complications if not treated quickly with antibiotics. [5] Doxycycline remains the preferred drug for persons with ehrlichiosis. [6] Currently recommended treatment regimens for human monocytic ehrlichiosis (HME) include doxycycline or tetracycline. [7] May 15, 2024 — Doxycycline is the treatment of choice for adults and children of all ages with ehrlichiosis. [8] Oct 26, 2022 — Ehrlichiosis patients typically respond dramatically to doxycycline therapy (100 mg twice daily until the patient is afebrile for at least 3 days). [9] Oct 3, 2024 — Treatment. Antibiotics (tetracycline or doxycycline) are used to treat the disease.
Recommended Medications
- Tetracycline antibiotics
- doxycycline
- Doxycycline
💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.
Differential Diagnosis
Differential Diagnosis of Human Monocytic Ehrlichiosis (HME)
Human monocytic ehrlichiosis (HME) is a tick-borne infectious disease caused by the bacterium Ehrlichia chaffeensis. The differential diagnosis for HME includes several other conditions that may present with similar symptoms. Here are some of the key differential diagnoses to consider:
- Typhoid fever: This bacterial infection can cause fever, headache, and abdominal pain, which are also symptoms of HME.
- Malaria: Malaria is a mosquito-borne disease that can cause fever, chills, and flu-like symptoms, similar to those experienced in HME.
- Babesiosis: This tick-borne disease can cause fever, fatigue, and anemia, which may be confused with the symptoms of HME.
- Human Granulocytic Ehrlichiosis (HGE): As a related condition, HGE is another tick-borne disease caused by Anaplasma phagocytophilum, which can present with similar symptoms to HME.
Key Symptoms and Signs
The differential diagnosis for HME requires careful consideration of the patient's symptoms and signs. Some key features to look out for include:
- Fever: A high fever is a common symptom in both HME and its differential diagnoses.
- Headache: Headaches are also a frequent complaint in patients with HME and other tick-borne diseases.
- Fatigue: Fatigue and weakness are common symptoms of HME, as well as other conditions such as babesiosis.
Diagnostic Tests
The diagnosis of HME is typically made through laboratory tests, including:
- Serology: Blood tests can detect the presence of antibodies against Ehrlichia chaffeensis, indicating a current or past infection.
- Polymerase chain reaction (PCR): This test can detect the genetic material of the bacterium in blood samples.
- Immunohistochemistry: This test can help confirm the diagnosis by detecting the presence of the bacterium in tissue samples.
References
- [4] Human ehrlichioses are emerging tickborne infections. “Human ehrlichiosis” describes infections with at least 5 separate obligate intracellular bacteria.
- [5] Differential diagnosis of HME includes human granulocytic anaplasmosis, Rocky Mountain spotted fever, viral illnesses (mononucleosis, Colorado tick fever, West ...
- [6] Ehrlichiosis can be identified by tests including serology, polymerase chain reaction, immunohistochemistry, culture, and blood-smear microscopy ...
- [7] The syndrome of human monocytic ehrlichiosis is a mild to severe, febrile multisystem illness. ... The differential diagnosis of ehrlichiosis is broad ...
- [8] Differential Diagnosis: RMSF, bacterial sepsis, Lyme disease, flea-borne typhus, babesiosis, and other tick-borne diseases.
Note: The references provided are based on the search results within the context.
Additional Differential Diagnoses
- Human Granulocytic Ehrlichiosis (HGE)
- Viral illnesses (mononucleosis, Colorado tick fever, West Nile virus)
- bacterial sepsis
- Rocky Mountain spotted fever
- typhus
- Lyme disease
- malaria
- typhoid fever
- babesiosis
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- An ehrlichiosis that results in infection located in monocyte or located in macrophage, has_material_basis_in Ehrlichia chaffeensis, which is transmitted by black-legged tick (Ixodes scapularis), transmitted by western black-legged tick (Ixodes pacificus) or transmitted by castor bean tick (Ixodes ricinus). The infection has symptom headache, has symptom muscle aches, has symptom fatigue, has symptom fever and has symptom rash.
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