Blood smears or buffy coat preparations can be examined for presence of morulae in the peripheral blood monocytes or granulocytes, but the test is insensitive. E. chaffeensis can be isolated by in-vitro cultivation of the clinical specimen but the test is also insensitive. However, this test is currently available only in research laboratories. Doxycycline is the drug of choice and results in rapid improvement of the condition within 24 to 48 hours. Most experts recommend the use of doxycycline for children younger than 8 years with human ehrlichiosis because it is superior to chloramphenicol, and staining of developing teeth by tetracycline drugs is dose related.
Doxycycline is less likely to stain developing teeth than is tetracycline.
DEET and permethrin must be used properly to avoid their toxicities. Daily careful inspection of the entire body and proper and prompt removal of any attached tick must occur after possible tick exposure. Prophylactic antibiotic therapy for tick bites is not warranted presently because the risk of infection is low. There is no human ehrlichia vaccine available in the United States. The Human Ehrlichiosis in the United States.