Ehrlichiosis

Ehrlichiosis

Ehrlichiosis
Classification and external resources
ICD-9-CM 082.4
MedlinePlus 001381
eMedicine article/235839
MeSH D016873

Ehrlichiosis is a tickborne[1] bacterial infection,[2] caused by bacteria of the family Anaplasmataceae, genera Ehrlichia and Anaplasma. These obligate intracellular bacteria infect and kill white blood cells.

The average reported annual incidence is 0.7 cases per million people.[3]

Contents

  • Species 1
  • Signs and symptoms 2
  • Treatment 3
  • Prevention 4
  • See also 5
  • References 6
  • External links 7

Species

Five (see note below) species have been shown to cause human infection:[4]

The latter two infections are not well studied. In 2006, human infection by Boone County, Missouri. Symptoms: high fever,severe joint and muscle aches, vomiting. Onset of symptoms began exactly 14 days after bite occurred. Symptoms affected patient on a 12-hour cycle; beginning early evening, ending early morning. No symptoms occurred for next 12 hours.

  • (RO) Ehrlichiosis in dogs. Real cases Ehrlichia cases in dogs. Case studies

External links

  1. ^
  2. ^
  3. ^ a b c
  4. ^
  5. ^
  6. ^ a b
  7. ^
  8. ^
  9. ^
  10. ^
  11. ^
return p

end

', table.concat(classes, ' '), s )
%s
function p._hatnote(s, options) checkType('_hatnote', 1, s, 'string') checkType('_hatnote', 2, options, 'table', true) local classes = {'hatnote'} local extraclasses = options.extraclasses local selfref = options.selfref if type(extraclasses) == 'string' then classes[#classes + 1] = extraclasses end if selfref then classes[#classes + 1] = 'selfref' end return string.format( '

function p.hatnote(frame) local args = getArgs(frame) local s = args[1] local options = {} if not s then return p.makeWikitextError( 'no text specified', 'Template:Hatnote#Errors', args.category ) end options.extraclasses = args.extraclasses options.selfref = args.selfref return p._hatnote(s, options) end


-- Hatnote -- -- Produces standard hatnote text. Implements the template.


function p._formatLink(link, display) -- Find whether we need to use the colon trick or not. We need to use the -- colon trick for categories and files, as otherwise category links -- categorise the page and file links display the file. checkType('_formatLink', 1, link, 'string') checkType('_formatLink', 2, display, 'string', true) link = removeInitialColon(link) local namespace = p.findNamespaceId(link, false) local colon if namespace == 6 or namespace == 14 then colon = ':' else colon = end -- Find whether a faux display value has been added with the | magic -- word. if not display then local prePipe, postPipe = link:match('^(.-)|(.*)$') link = prePipe or link display = postPipe end -- Find the display value. if not display then local page, section = link:match('^(.-)#(.*)$') if page then display = page .. ' § ' .. section end end -- Assemble the link. if display then return string.format('%s', colon, link, display) else return string.format('%s%s', colon, link) end end

function p.formatLink(frame) local args = getArgs(frame) local link = args[1] local display = args[2] if not link then return p.makeWikitextError( 'no link specified', 'Template:Format hatnote link#Errors', args.category ) end return p._formatLink(link, display) end


-- Format link -- -- Makes a wikilink from the given link and display values. Links are escaped -- with colons if necessary, and links to sections are detected and displayed -- with " § " as a separator rather than the standard MediaWiki "#". Used in -- the template.


function p.makeWikitextError(msg, helpLink, addTrackingCategory) -- Formats an error message to be returned to wikitext. If -- addTrackingCategory is not false after being returned from -- Module:Yesno, and if we are not on a talk page, a tracking category -- is added. checkType('makeWikitextError', 1, msg, 'string') checkType('makeWikitextError', 2, helpLink, 'string', true) yesno = require('Module:Yesno') local title = mw.title.getCurrentTitle() -- Make the help link text. local helpText if helpLink then helpText = ' (help)' else helpText = end -- Make the category text. local category if not title.isTalkPage and yesno(addTrackingCategory) ~= false then category = 'Hatnote templates with errors' category = string.format( '%s:%s', mw.site.namespaces[14].name, category ) else category = end return string.format( '%s', msg, helpText, category ) end

function p.formatPageTables(...) -- Takes a list of page/display tables and returns it as a list of -- formatted links. Nil values are not allowed. local pages = {...} local links = {} for i, t in ipairs(pages) do checkType('formatPageTables', i, t, 'table') local link = t[1] local display = t[2] links[i] = p._formatLink(link, display) end return links end

function p.formatPages(...) -- Formats a list of pages using formatLink and returns it as an array. Nil -- values are not allowed. local pages = {...} local ret = {} for i, page in ipairs(pages) do ret[i] = p._formatLink(page) end return ret end

function p.findNamespaceId(link, removeColon) -- Finds the namespace id (namespace number) of a link or a pagename. This -- function will not work if the link is enclosed in double brackets. Colons -- are trimmed from the start of the link by default. To skip colon -- trimming, set the removeColon parameter to true. checkType('findNamespaceId', 1, link, 'string') checkType('findNamespaceId', 2, removeColon, 'boolean', true) if removeColon ~= false then link = removeInitialColon(link) end local namespace = link:match('^(.-):') if namespace then local nsTable = mw.site.namespaces[namespace] if nsTable then return nsTable.id end end return 0 end

local function removeInitialColon(s) -- Removes the initial colon from a string, if present. return s:match('^:?(.*)') end

local function getArgs(frame) -- Fetches the arguments from the parent frame. Whitespace is trimmed and -- blanks are removed. mArguments = require('Module:Arguments') return mArguments.getArgs(frame, {parentOnly = true}) end


-- Helper functions


local p = {}

local libraryUtil = require('libraryUtil') local checkType = libraryUtil.checkType local mArguments -- lazily initialise Module:Arguments local yesno -- lazily initialise Module:Yesno


return p-------------------------------------------------------------------------------- -- Module:Hatnote -- -- -- -- This module produces hatnote links and links to related articles. It -- -- implements the and meta-templates and includes -- -- helper functions for other Lua hatnote modules. --

end

', table.concat(classes, ' '), s )
%s
function p._hatnote(s, options) checkType('_hatnote', 1, s, 'string') checkType('_hatnote', 2, options, 'table', true) local classes = {'hatnote'} local extraclasses = options.extraclasses local selfref = options.selfref if type(extraclasses) == 'string' then classes[#classes + 1] = extraclasses end if selfref then classes[#classes + 1] = 'selfref' end return string.format( '

function p.hatnote(frame) local args = getArgs(frame) local s = args[1] local options = {} if not s then return p.makeWikitextError( 'no text specified', 'Template:Hatnote#Errors', args.category ) end options.extraclasses = args.extraclasses options.selfref = args.selfref return p._hatnote(s, options) end


-- Hatnote -- -- Produces standard hatnote text. Implements the template.


function p._formatLink(link, display) -- Find whether we need to use the colon trick or not. We need to use the -- colon trick for categories and files, as otherwise category links -- categorise the page and file links display the file. checkType('_formatLink', 1, link, 'string') checkType('_formatLink', 2, display, 'string', true) link = removeInitialColon(link) local namespace = p.findNamespaceId(link, false) local colon if namespace == 6 or namespace == 14 then colon = ':' else colon = end -- Find whether a faux display value has been added with the | magic -- word. if not display then local prePipe, postPipe = link:match('^(.-)|(.*)$') link = prePipe or link display = postPipe end -- Find the display value. if not display then local page, section = link:match('^(.-)#(.*)$') if page then display = page .. ' § ' .. section end end -- Assemble the link. if display then return string.format('%s', colon, link, display) else return string.format('%s%s', colon, link) end end

function p.formatLink(frame) local args = getArgs(frame) local link = args[1] local display = args[2] if not link then return p.makeWikitextError( 'no link specified', 'Template:Format hatnote link#Errors', args.category ) end return p._formatLink(link, display) end


-- Format link -- -- Makes a wikilink from the given link and display values. Links are escaped -- with colons if necessary, and links to sections are detected and displayed -- with " § " as a separator rather than the standard MediaWiki "#". Used in -- the template.


function p.makeWikitextError(msg, helpLink, addTrackingCategory) -- Formats an error message to be returned to wikitext. If -- addTrackingCategory is not false after being returned from -- Module:Yesno, and if we are not on a talk page, a tracking category -- is added. checkType('makeWikitextError', 1, msg, 'string') checkType('makeWikitextError', 2, helpLink, 'string', true) yesno = require('Module:Yesno') local title = mw.title.getCurrentTitle() -- Make the help link text. local helpText if helpLink then helpText = ' (help)' else helpText = end -- Make the category text. local category if not title.isTalkPage and yesno(addTrackingCategory) ~= false then category = 'Hatnote templates with errors' category = string.format( '%s:%s', mw.site.namespaces[14].name, category ) else category = end return string.format( '%s', msg, helpText, category ) end

function p.formatPageTables(...) -- Takes a list of page/display tables and returns it as a list of -- formatted links. Nil values are not allowed. local pages = {...} local links = {} for i, t in ipairs(pages) do checkType('formatPageTables', i, t, 'table') local link = t[1] local display = t[2] links[i] = p._formatLink(link, display) end return links end

function p.formatPages(...) -- Formats a list of pages using formatLink and returns it as an array. Nil -- values are not allowed. local pages = {...} local ret = {} for i, page in ipairs(pages) do ret[i] = p._formatLink(page) end return ret end

function p.findNamespaceId(link, removeColon) -- Finds the namespace id (namespace number) of a link or a pagename. This -- function will not work if the link is enclosed in double brackets. Colons -- are trimmed from the start of the link by default. To skip colon -- trimming, set the removeColon parameter to true. checkType('findNamespaceId', 1, link, 'string') checkType('findNamespaceId', 2, removeColon, 'boolean', true) if removeColon ~= false then link = removeInitialColon(link) end local namespace = link:match('^(.-):') if namespace then local nsTable = mw.site.namespaces[namespace] if nsTable then return nsTable.id end end return 0 end

local function removeInitialColon(s) -- Removes the initial colon from a string, if present. return s:match('^:?(.*)') end

local function getArgs(frame) -- Fetches the arguments from the parent frame. Whitespace is trimmed and -- blanks are removed. mArguments = require('Module:Arguments') return mArguments.getArgs(frame, {parentOnly = true}) end


-- Helper functions


local p = {}

local libraryUtil = require('libraryUtil') local checkType = libraryUtil.checkType local mArguments -- lazily initialise Module:Arguments local yesno -- lazily initialise Module:Yesno


-- Module:Hatnote -- -- -- -- This module produces hatnote links and links to related articles. It -- -- implements the and meta-templates and includes -- -- helper functions for other Lua hatnote modules. --


References

See also

No human vaccine is available for ehrlichiosis. Tick control is the main preventive measure against the disease. However, in late 2012 a breakthrough in the prevention of CME (canine monocytic ehrlichiosis) was announced when a vaccine was accidentally discovered by Prof. Shimon Harrus, Dean of the Hebrew University of Jerusalem's Koret School of Veterinary Medicine.[11]

Prevention

-- based on setting/preference specify order local orderlist = {"c", "s", "t", "p", "tp", "w", "j", "cy", "poj", "zhu", "l"} if (t1) then orderlist[2] = "t" orderlist[3] = "s" end if (j1) then orderlist[4] = "j" orderlist[5] = "cy" orderlist[6] = "p" orderlist[7] = "tp" orderlist[8] = "w" end -- rename rules. Rules to change parameters and labels based on other parameters if args["hp"] then -- hp an alias for p ([hanyu] pinyin) args["p"] = args["hp"] end if args["tp"] then -- if also Tongyu pinyin use full name for Hanyu pinyin labels["p"] = "Hanyu Pinyin" end if (args["s"] and args["s"] == args["t"]) then -- Treat simplified + traditional as Chinese if they're the same args["c"] = args["s"] args["s"] = nil args["t"] = nil elseif (not (args["s"] and args["t"])) then -- use short label if only one of simplified and traditional labels["s"] = labels["c"] labels["t"] = labels["c"] end local body = "" -- the output string local params -- for creating HTML spans local label -- the label, i.e. the bit preceeding the supplied text local val -- the supplied text -- go through all possible fields in loop, adding them to the output for i, part in ipairs(orderlist) do if (args[part]) then -- build label label = "" if (uselabels) then label = labels[part] if (capfirst) then label = mw.language.getContentLanguage():ucfirst(

        local t1 = false -- whether traditional Chinese characters go first
        local j1 = false -- whether Cantonese Romanisations go first
        local testChar
        if (args["first"]) then
                 for testChar in mw.ustring.gmatch(args["first"], "%a+") do
          if (testChar == "t") then
           t1 = true
           end
          if (testChar == "j") then
           j1 = true
           end
         end
        end
        if (t1 == false) then
         local title = mw.title.getCurrentTitle()
         t1 = t1st[title.text] == true
        end

function p.Zh(frame) -- load arguments module to simplify handling of args local getArgs = require('Module:Arguments').getArgs local args = getArgs(frame) return p._Zh(args) end function p._Zh(args) local uselinks = not (args["links"] == "no") -- whether to add links local uselabels = not (args["labels"] == "no") -- whether to have labels local capfirst = args["scase"] ~= nil

local italic = { ["p"] = true, ["tp"] = true, ["w"] = true, ["j"] = true, ["cy"] = true, ["poj"] = true, } -- Categories for different kinds of Chinese text local cats = { ["c"] = "", ["s"] = "", ["t"] = "", }

-- for those parts which are to be treated as languages their ISO code local ISOlang = { ["c"] = "zh", ["t"] = "zh-Hant", ["s"] = "zh-Hans", ["p"] = "zh-Latn-pinyin", ["tp"] = "zh-Latn", ["w"] = "zh-Latn-wadegile", ["j"] = "yue-jyutping", ["cy"] = "yue", ["poj"] = "hak", ["zhu"] = "zh-Bopo", }

-- article titles for wikilinks for each part local wlinks = { ["c"] = "Chinese language", ["s"] = "simplified Chinese characters", ["t"] = "traditional Chinese characters", ["p"] = "pinyin", ["tp"] = "Tongyong Pinyin", ["w"] = "Wade–Giles", ["j"] = "Jyutping", ["cy"] = "Yale romanization of Cantonese", ["poj"] = "Pe̍h-ōe-jī", ["zhu"] = "Bopomofo", }

-- the labels for each part local labels = { ["c"] = "Chinese", ["s"] = "simplified Chinese", ["t"] = "traditional Chinese", ["p"] = "pinyin", ["tp"] = "Tongyong Pinyin", ["w"] = "Wade–Giles", ["j"] = "Jyutping", ["cy"] = "Cantonese Yale", ["poj"] = "Pe̍h-ōe-jī", ["zhu"] = "Zhuyin Fuhao", ["l"] = "literally", }

-- articles in which traditional Chinese preceeds simplified Chinese local t1st = { ["228 Incident"] = true, ["Chinese calendar"] = true, ["Lippo Centre, Hong Kong"] = true, ["Republic of China"] = true, ["Republic of China at the 1924 Summer Olympics"] = true, ["Taiwan"] = true, ["Taiwan (island)"] = true, ["Taiwan Province"] = true, ["Wei Boyang"] = true, }

local p = {}

Doxycycline and minocycline are the medications of choice. For people allergic to antibiotics of the tetracycline class, rifampin is an alternative.[3] Early clinical experience suggested that chloramphenicol may also be effective, however, in vitro susceptibility testing revealed resistance.require('Module:No globals')

Treatment

3% of human monocytic ehrlichiosis cases result in death; however, these deaths occur "most commonly in immunosuppressed individuals who develop respiratory distress syndrome, hepatitis, or opportunistic nosocomial infections."[10]

Experiments in mouse models further supports this hypothesis, as mice lacking TNF-alpha I/II receptors are resistant to liver injury caused by ehrlichia infection.[9]

[8] Late in infection, however, production of this substance can be upregulated by 30 fold, which is likely responsible for the "

Most of the signs and symptoms of ehrlichiosis can likely be ascribed to the immune dysregulation that it causes.

-- based on setting/preference specify order local orderlist = {"c", "s", "t", "p", "tp", "w", "j", "cy", "poj", "zhu", "l"} if (t1) then orderlist[2] = "t" orderlist[3] = "s" end if (j1) then orderlist[4] = "j" orderlist[5] = "cy" orderlist[6] = "p" orderlist[7] = "tp" orderlist[8] = "w" end -- rename rules. Rules to change parameters and labels based on other parameters if args["hp"] then -- hp an alias for p ([hanyu] pinyin) args["p"] = args["hp"] end if args["tp"] then -- if also Tongyu pinyin use full name for Hanyu pinyin labels["p"] = "Hanyu Pinyin" end if (args["s"] and args["s"] == args["t"]) then -- Treat simplified + traditional as Chinese if they're the same args["c"] = args["s"] args["s"] = nil args["t"] = nil elseif (not (args["s"] and args["t"])) then -- use short label if only one of simplified and traditional labels["s"] = labels["c"] labels["t"] = labels["c"] end local body = "" -- the output string local params -- for creating HTML spans local label -- the label, i.e. the bit preceeding the supplied text local val -- the supplied text -- go through all possible fields in loop, adding them to the output for i, part in ipairs(orderlist) do if (args[part]) then -- build label label = "" if (uselabels) then label = labels[part] if (capfirst) then label = mw.language.getContentLanguage():ucfirst(

        local t1 = false -- whether traditional Chinese characters go first
        local j1 = false -- whether Cantonese Romanisations go first
        local testChar
        if (args["first"]) then
                 for testChar in mw.ustring.gmatch(args["first"], "%a+") do
          if (testChar == "t") then
           t1 = true
           end
          if (testChar == "j") then
           j1 = true
           end
         end
        end
        if (t1 == false) then
         local title = mw.title.getCurrentTitle()
         t1 = t1st[title.text] == true
        end

function p.Zh(frame) -- load arguments module to simplify handling of args local getArgs = require('Module:Arguments').getArgs local args = getArgs(frame) return p._Zh(args) end function p._Zh(args) local uselinks = not (args["links"] == "no") -- whether to add links local uselabels = not (args["labels"] == "no") -- whether to have labels local capfirst = args["scase"] ~= nil

local italic = { ["p"] = true, ["tp"] = true, ["w"] = true, ["j"] = true, ["cy"] = true, ["poj"] = true, } -- Categories for different kinds of Chinese text local cats = { ["c"] = "", ["s"] = "", ["t"] = "", }

-- for those parts which are to be treated as languages their ISO code local ISOlang = { ["c"] = "zh", ["t"] = "zh-Hant", ["s"] = "zh-Hans", ["p"] = "zh-Latn-pinyin", ["tp"] = "zh-Latn", ["w"] = "zh-Latn-wadegile", ["j"] = "yue-jyutping", ["cy"] = "yue", ["poj"] = "hak", ["zhu"] = "zh-Bopo", }

-- article titles for wikilinks for each part local wlinks = { ["c"] = "Chinese language", ["s"] = "simplified Chinese characters", ["t"] = "traditional Chinese characters", ["p"] = "pinyin", ["tp"] = "Tongyong Pinyin", ["w"] = "Wade–Giles", ["j"] = "Jyutping", ["cy"] = "Yale romanization of Cantonese", ["poj"] = "Pe̍h-ōe-jī", ["zhu"] = "Bopomofo", }

-- the labels for each part local labels = { ["c"] = "Chinese", ["s"] = "simplified Chinese", ["t"] = "traditional Chinese", ["p"] = "pinyin", ["tp"] = "Tongyong Pinyin", ["w"] = "Wade–Giles", ["j"] = "Jyutping", ["cy"] = "Cantonese Yale", ["poj"] = "Pe̍h-ōe-jī", ["zhu"] = "Zhuyin Fuhao", ["l"] = "literally", }

-- articles in which traditional Chinese preceeds simplified Chinese local t1st = { ["228 Incident"] = true, ["Chinese calendar"] = true, ["Lippo Centre, Hong Kong"] = true, ["Republic of China"] = true, ["Republic of China at the 1924 Summer Olympics"] = true, ["Taiwan"] = true, ["Taiwan (island)"] = true, ["Taiwan Province"] = true, ["Wei Boyang"] = true, }

local p = {}

The most common symptoms include headache, muscle aches, and fatigue. A rash may occur, but is uncommon. Ehrlichiosis can also blunt the immune system by suppressing production of TNF-alpha, which may lead to opportunistic infections such as candidiasis.require('Module:No globals')

Signs and symptoms

Ehrlichia are transported between cells through the host cell filopodia during initial stages of infection, whereas, in the final stages of infection the pathogen ruptures the host cell membrane.[7]

[6] hospital.Eau Claire Health System's Mayo Clinic, was identified at E. muris called Japan and Eastern Europe species found in Ehrlichia The new species, which is very similar genetically to an [6] was reported; human ehrlichiosis was thought to be very rare or absent in Minnesota and Wisconsin.Wisconsin and Minnesota symptoms in at least 25 people in flu-like that has caused deer ticks carried by Ehrlichia On August 3, 2011, infection by a yet-unnamed bacterium in the genus [5]