Diferencia entre revisiones de «Ehrlichiosis»
(added leukopenia...) |
Sin resumen de edición |
||
| Línea 1: | Línea 1: | ||
==Background== | ==Background== | ||
*Bacterial infection of the family Anaplasmataceae | *Bacterial infection of the family Anaplasmataceae common in mammals such as cattle, dogs, sheep, goats, and horses<ref>CDC. Ehrlichiosis. http://www.cdc.gov/ehrlichiosis.</re> | ||
*Spread by the Lonestar tick (Amblyomma americanum) | *Spread by the Lonestar tick (Amblyomma americanum) [[File:Lone Star Tick.jpg|thumb|Lone Star Tick (preserved]] | ||
**Eastern seaboard from Florida to Maine and as far west as Iowa and Texas | **Eastern seaboard from Florida to Maine and as far west as Iowa and Texas | ||
**People often unaware they are bitten | **People often unaware they are bitten with case fatality rate of approximately 1.8%<ref>CDC http://www.cdc.gov/ehrlichiosis/stats/</ref> | ||
**More severe disease in immunocompromised patients ([[HIV]], Elderly, '''Asplenic''') | |||
**More severe disease in immunocompromised patients (HIV, Elderly, '''Asplenic''') | |||
==Symptoms== | ==Symptoms== | ||
| Línea 12: | Línea 11: | ||
==Diagnosis== | ==Diagnosis== | ||
*'''Peripheral blood smear'''<ref>http://www.cdc.gov/ehrlichiosis/symptoms/index.html#diagnosis</ref> | |||
*Obligate intracellular organism | *Obligate intracellular organism | ||
** | **Smear shows intracellular parasites only 20% of time | ||
*PCR | *'''PCR''' | ||
**Most sensitive in first week of illness | **Most sensitive in first week of illness | ||
*Indirect Immunoflorescence Assay | *'''Indirect Immunoflorescence Assay'''' | ||
** | **''Gold Standard'' | ||
**Negative 85% of time in first 7 days of illness | **Negative 85% of time in first 7 days of illness | ||
**Compare 2 samples drawn at different times | **Compare 2 samples drawn at different times | ||
**4 fold increase in titers of second draw is positive | |||
*Enzyme Immunoassay | *'''Enzyme Immunoassay''' | ||
**Qualitative tests, not quantitative | **Qualitative tests, not quantitative | ||
*Leukopenia, elevated transaminases, thrombocytopenia often present | *Leukopenia, elevated transaminases, thrombocytopenia often present | ||
| Línea 34: | Línea 34: | ||
==Sources== | ==Sources== | ||
<references/> | |||
[[Category:ID]] | [[Category:ID]] | ||
Revisión del 19:46 5 dic 2014
Background
- Bacterial infection of the family Anaplasmataceae common in mammals such as cattle, dogs, sheep, goats, and horsesError en la cita: Etiqueta de apertura
<ref>sin su correspondiente cierre</ref>- More severe disease in immunocompromised patients (HIV, Elderly, Asplenic)
Symptoms
- Fever, chills, headache, malaise, myalgias, nausea, vomiting, diarrhea, conjunctival injection
- Up to 60% of children may have a rash (30% of adults)
Diagnosis
- Peripheral blood smear[1]
- Obligate intracellular organism
- Smear shows intracellular parasites only 20% of time
- PCR
- Most sensitive in first week of illness
- Indirect Immunoflorescence Assay'
- Gold Standard
- Negative 85% of time in first 7 days of illness
- Compare 2 samples drawn at different times
- 4 fold increase in titers of second draw is positive
- Enzyme Immunoassay
- Qualitative tests, not quantitative
- Leukopenia, elevated transaminases, thrombocytopenia often present
Treatment
- Doxycycline
- 100mg BID (Adults)
- 2.2mg/kg BID (children)