Illness can range from a mild self-limited infection to severe hemolytic anemia, renal failure, and severe hypertension. Decreased levels of blood platelets may necessitate exchange blood transfusions. Most patients have thrombocytopenia. Wright's or Giemsa-stained blood smears may reveal babesia organisms. Elevated titers can persist for months after acute infection.
Most patients have a mild illness and recover without specific treatment.
A 7-day regimen of oral quinine plus oral or intravenous clindamycin is recommended. Blood transfusions are given in severe cases. Fatigue and low-grade fever may persist for weeks or months after treatment. The latest tick-borne disease to emerge in the U.S., ehrlichiosis was first described in 1987. Much less common than either Lyme disease or Rocky Mountain spotted fever, an average of 50 cases of ehrlichiosis are reported each year.