The patient may be confused. Ehrlichia species, members of the family Rickettsiae, are gram-negative, obligate, intracellular coccobacilli that resemble Rickettsia species. A positive PCR is considered as an alternative to confirm infection. Abnormal cerebrospinal fluid also can be observed. Only a minority of patients with HME have detectable morulae.
Early treatment is critical.
Consider the possibility of ehrlichiosis when patients have a febrile illness and history of recent tick exposure. Doxycycline remains the drug of choice for persons infected with ehrlichia. Current data recommend continuation of treatment until the patient has been afebrile for at least 3 days and for a minimum of 5-7 days. Treat patients with ehrlichiosis in consultation with an infectious disease physician. Antibiotics - Doxycycline is the treatment of choice.