Sudden Illness in a Highly Active 80-Year-Old Woman

Zafar Jamkhana, MD, MPH; Nirav Patel, MD

Disclosures

February 12, 2019

Because diagnosis of ehrlichiosis requires a high index of suspicion and is frequently delayed because of the prolonged testing time, empiric therapy is frequently used. Furthermore, delay in appropriate antibiotic therapy is a risk factor for increased morbidity.

The drug of choice for E chaffeensis infection, A phagocytophilum infection, and Rocky Mountain spotted fever is doxycycline. Rifampin is considered an alternative, but has substantially less supportive evidence, and doxycycline is suggested even in children and during pregnancy if the clinical concern is great for these infections.[2] Chloramphenicol, ciprofloxacin, erythromycin, trimethoprim-sulfamethoxazole, penicillin, and gentamicin were found not to be active against E chaffeensis in an in vitro model.[6]

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