Predictors of Kuriakose et al for Severe Ehrlichiosis

Patient selection: ehrlichiosis (confirmed by PCR)

Risk factors for fatal infection:

(1) age less than 5 years or older than 70 years

Findings associated with ICU admission:

(1) delay in time to treatment with doxycycline

(2) shortness of breath

(3) altered mentation

(4) seizures

(5) rash

(6) acute kidney injury

(7) moderate or severe thrombocytopenia

(8) evidence of liver injury (higher serum AST, higher serum bilirubin)

Factors associated with a lower risk of ICU admission (possibly due to early initiation of appropriate therapy):

(1) documented tick exposure

(2) immunosuppression

Serologic diagnosis is limited by delayed seroconversion and inconsistent paired specimen testing. PCR may be negative in mild cases with small number of organisms.