create upc barcode in excel OTHER RICKETTSIAL & RICKETTSIAL-LIKE DISEASES 1 Ehrlichiosis & Anaplasmosis in Objective-C

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OTHER RICKETTSIAL & RICKETTSIAL-LIKE DISEASES 1 Ehrlichiosis & Anaplasmosis
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Infection of monocyte or granulocyte by tick-borne gram-negative bacteria Nine-day incubation period, with variable clinical illness, ranging from asymptomatic to persistent or life-threatening Common symptoms are malaise, nausea, fever, and headaches Excellent response to therapy with tetracyclines
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The term tick typhus denotes a variety of spotted rickettsial fevers They are often named by geography, eg, Mediterranean spotted fever, Queensland tick typhus, Oriental spotted fever, African tick bite fever, Siberian tick typhus, North Asian tick typhus, or by morphology, eg, boutonneuse fever These illnesses are transmitted by tick vectors of the rickettsial organisms R conorii, R australis, R japonica, R africae, and R sibirica (Table 32 3) Dogs and wild animals, usually rodents but even reptiles, may serve as reservoirs The pathogens usually produce an eschar or black spot (tache noire) at the site of the tick bite that may be useful in diagnosis, though spotless boutonneuse fever occurs Symptoms include fever, headache, myalgias, and rash Rarely, papulovesicular lesions may resemble rickettsialpox Endothelial injury produces perivascular edema and dermal necrosis Regional adenopathy, disseminated lesions, renal failure, and focal hepatic necrosis may occur Diabetes, dehydration, and uremia were risk factors for mortality in one series The disease occurs among travelers, the most common travel-associated rick-
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Ehrlichiosis and its analogous disease anaplasmosis present as two clinical entities involving either the monocyte or the granulocyte Human monocytic ehrlichiosis is caused by Ehrlichia chaffeensis and by Ehrlichia canis (Table 32 3) Human granulocytic ehrlichiosis (anaplasmosis) is caused by Anasplasma phagocytophilium and Ehrlichia ewingii Another rickettsia-like organism, Neorickettsia sennetsu, is the etiologic agent of sennetsu fever, which appears to be confined to western Japan
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Wormser GP et al The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical practice guidelines by the Infectious Diseases Society of America Clin Infect Dis 2006 Nov 1;43(9):1089 134 [PMID: 17029130]
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Ehrlichiae and anaplasmae are small tick-borne gramnegative obligate intracellular bacteria The major nonhuman hosts include mice, dogs, and horses These organisms grow as microcolonies in phagosomes of hematopoietic cells and form characteristic inclusions seen with Giemsa stain Human monocytic ehrlichiosis is seen primarily in the Southeast, mid-Atlantic, and South Central states of the United States, though serologic evidence now documents a much more global endemicity (Israel, Japan, Mexico, Europe) Its major vectors are the Lone Star tick (Amblyomma americanus) and the American dog tick (D variabilis) Reported incidences of both human monocytic and granulocytic ehrlichiosis are about 06 and 14 per million, respectively, with the highest attack rate in men over 60 years of age Clinical disease ranges from mild to life-threatening Typically, after about a 9-day incubation period and a prodrome consisting of malaise, rigors, and nausea, worsening fever and headache develop A pleomorphic rash may occur Infections among HIV-positive persons are more apt to be symptomatic Disease is more severe among the elderly Leukopenia, absolute lymphopenia, thrombocytopenia, and transaminitis occur often Serious sequelae include acute respiratory failure and ARDS, encephalopathy, and acute renal failure, which may mimic thrombotic thrombocytopenic purpura Human granulocytic ehrlichiosis (anaplasmosis) has an increasingly recognized ubiquitous geographic area of distribution with clinically consistent cases now reported from the United States (where it is tends to be present in the same geographic area as Borrelia burgdorferi, the causative agent of Lyme disease), Brazil, Israel, and Europe The vectors are ticks of the Ixodes genus, and the reservoirs include woodrats, deer mice, chipmunks, deer, and perhaps horses The incidence peaks in summer, but cases are seen year-round in warmer areas where ticks remain viable The symptoms are similar to those seen with human monocytic ehrlichiosis Persistent fever and malaise are reported to occur for 2 or more years Coinfection with Lyme disease may occur, though patients with granulocytic ehrlichiosis appear to be older and sicker than those with acute Lyme disease
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