Rickettsial and ehrlichial infections

Cerebral haemorrhage as a clinical manifestation of human ehrlichiosis

“…Further cases of CNS involvement have been described in up to 20% to 70% of patients with human monocytic ehrlichiosis 4 8 9 11. In children, CNS manifestations comprise hyper-reflexia, meningismus, confusion, broad-based gait, cranial neuropathy, ataxia and seizures 11. Long-term language and motor neurological sequelae have been occasionally observed 11 12.…”

Tick-Borne-Associated Illnesses in the Pediatric Intensive Care Unit

“…HGA and HME are rickettsial infections. 46,47 HGA infects the neutrophils while HME infects monocytes and macrophages. 48 HGA is endemically found within the Midwest and northeastern areas and its principal tick vector is Ixodes scapularis with an incubation period of 5 to 14 days.…”

“…28,46 HME is mainly in the southcentral, southeastern, and mid-Atlantic regions and its tick vector is the lone star tick (Ambylomma americanum) with an incubation period of 5 to 14 days. 47,49 Most cases are diagnosed between April and September. 32,46,47 While reportedly rare, their prevalence is likely underreported in children due to mild infections that do not require medical care.…”

“…47,49 Most cases are diagnosed between April and September. 32,46,47 While reportedly rare, their prevalence is likely underreported in children due to mild infections that do not require medical care. 46…”

“…Clinical manifestations of HGA and HME are often nonspecific, including rash, fever, malaise, chills, headache, myalgias, and abdominal pain. 34,46,47,50 Neurologic manifestations are most commonly seen with HME. 47 Life-threatening clinical signs seen in HGA and HME include encephalopathy, seizures, respiratory failure, shock, cardiac failure, myocarditis, and acute renal failure.…”