Infectious Disease Book

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Human Granulocytic AnaplasmosisAka: HGA, Anaplasma phagocytophila, Human Granulocytic Ehrlichiosis, Ehrlichia equi, Ehrlichia phagocytophila, Ehrlichiosis

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  1. See also
    1. Human Monocytic Ehrlichiosis
    2. Vector Borne Disease
    3. Prevention of Tick-borne Infection
    4. Tick Removal
  2. Pathophysiology
    1. Transmission: Tick bite
    2. Small gram-negative organisms
      1. Pleomorphic
      2. Obligate intracellular organisms
    3. Disease: Human Granulocytic Anaplasmosis (HGA)
      1. Previously known as: Human Granulocytic Ehrlichiosis
    4. Causative Organism
      1. New Name: Anaplasma phagocytophila
      2. Prior Name: Ehrilichia phagocytophila, E. equi
  3. Epidemiology
    1. Majority of cases occur April to September
    2. Tick Carriers
      1. Deer Tick (Ixodes Scapularis)
      2. Dog tick (Dermacentor variabilis)
    3. United States endemic areas
      1. Minnesota
      2. Wyoming
      3. New York
  4. Symptoms (Occur 7-10 days after tick bite)
    1. Common Initial Symptoms
      1. Fever
      2. Shaking chills
      3. Myalgia
      4. Headache
    2. Other symptoms
      1. Nausea and Vomiting
      2. Abdominal Pain
      3. Diarrhea
      4. Cough
      5. Confusion
  5. Signs: Rash (occurs in <10% of patients)
    1. Involves trunk
    2. Spares hands and feet
    3. Not associated with tick bite site
  6. Labs
    1. Complete Blood Count
      1. Leukopenia
      2. Thrombocytopenia
      3. Mild transient Anemia
    2. Liver transaminases increased
      1. Aspartate Aminotransferase (AST) increased
      2. Alanine Aminotransferase (ALT) increased
    3. Ehrlichiosis Serology
      1. Positive two weeks after onset
      2. Used for confirmation, not for diagnosis
    4. Other variably present laboratory findings
      1. Increased Erythrocyte Sedimentation Rate (ESR)
      2. Increased Blood Urea Nitrogen (BUN)
      3. Increased Serum Creatinine
  7. Management: Antibiotics for two weeks
    1. Doxycycline or
    2. Chloramphenicol or
    3. Rifampin
  8. Prevention
    1. See Prevention of Vector-borne Infection
  9. References
    1. (1995) MMWR Morb Mortal Wkly Rep 44:593
    2. Fritz (1998) Infect Dis Clin North Am 12:123
    3. Glushko (1997) Postgrad Med 101(6):225
    4. McQuiston (1999) Emerg Infect Dis 5:635
    5. Weinstein (1996) Am Fam Physician 54(6):1971

Ehrlichiosis (C0085399)

Definition (MSH)A tick-borne disease characterized by FEVER; HEADACHE; myalgias; ANOREXIA; and occasionally RASH. It is caused by several bacterial species and can produce disease in DOGS; CATTLE; SHEEP; GOATS; HORSES; and humans. The primary species causing human disease are EHRLICHIA CHAFFEENSIS; ANAPLASMA PHAGOCYTOPHILUM; and Ehrlichia ewingii.
Definition (CSP)febrile illness caused by infection with Ehrlichia species.
ConceptsDisease or Syndrome (T047)
ICD9082.4
EnglishEhrlichioses, Ehrlichiosis, Erlichiosis
Spanishehrliquiosis
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Anaplasma phagocytophilum (bacteria) (C0318329)

Definition (MSH)A species of gram-negative bacteria in the genus ANAPLASMA, family ANAPLASMATACEAE, formerly called Ehrlichia phagocytophila or Ehrlichia equi. This organism is tick-borne (IXODES) and causes disease in horses and sheep. In humans, it causes human granulocytic EHRLICHIOSIS.
ConceptsRickettsia or Chlamydia (T006)
Englishagent of human granulocytic ehrlichiosis, Anaplasma phagocytophila, Anaplasma phagocytophilum, Cytoecetes bovis, Cytoecetes phagocytophila, Ehrlichia equi, Ehrlichia equi Lewis et al. 1988, Ehrlichia phagocytophila, HGE agent, human granulocytic Ehrlichia, Rickettsia phagocytophila, Rickettsia phagocytophila ovis
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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