Erliquiosis y Anaplasmosis

Características Generales

Características básicas de Ehrlichia y Anaplasma

• Gram negativas
• Bacterias intracelulares obligadas
• Cocobacilos
• Crecen en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum vacuolas unidas a la membrana en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria leucocitos, particularmente:
  • Monocitos
  • Granulocitos
• Microscopía de luz:
  • Los LOS Neisseria organismos individuales son difíciles de observar.
  • Frecuentemente, se visualiza como mórula (microcolonia de organismos dentro de una vacuola)
  • Tinciones:
    • Wright
    • Giemsa

Especies clínicamente relevantes

Las especies más destacadas son:

• Ehrlichia chaffeensis Ehrlichia chaffeensis A species of gram-negative bacteria that is the causative agent of human ehrlichiosis. This organism was first discovered at fort chaffee, arkansas, when blood samples from suspected human ehrlichiosis patients were studied. Ehrlichiosis and Anaplasmosis → erliquiosis monocítica humana
• Anaplasma phagocytophilum Anaplasma phagocytophilum A species of gram-negative bacteria in the genus anaplasma, family anaplasmataceae, formerly called ehrlichia phagocytophila or ehrlichia equi. This organism is tick-borne (ixodes) and causes disease in horses and sheep. In humans, it causes human granulocytic ehrlichiosis. Ehrlichiosis and Anaplasmosis → anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana

Causas raras de erliquiosis en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum humanos:

• E. ewingii
• E. muris eauclairensis

Epidemiología y Factores de Riesgo

Epidemiología

• Incidencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos:
  • Erliquiosis monocítica humana: 3,2 casos por millón al AL Amyloidosis año
  • Anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana: 6,3 casos por millón al AL Amyloidosis año
• Zonas endémicas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos:
  • Erliquiosis monocítica humana:
    • Sureste
    • Centro-Sur
    • Atlántico – Medio
  • Anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana:
    • Noreste
    • Alto Medio Oeste y Grandes Lagos
• Zonas endémicas fuera de Estados Unidos:
  • Europa
  • Sudeste de Asia ASIA Spinal Cord Injuries
  • América del Sur
• La incidencia es mayor en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hombres que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las mujeres.
• Suele ocurrir entre abril y septiembre

Factores de riesgo

Para erliquiosis/ anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis:

• Viajar a o vivir en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una zona endémica
• Tener mascotas
• Participar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum actividades al AL Amyloidosis aire libre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum zonas boscosas:
  • Camping
  • Senderismo
  • Caza

Para enfermedad grave:

• Inmunosupresión:
  • Infección por virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de inmunodeficiencia humana (VIH)
  • Quimioterapia
  • Trasplante de órganos
• Las personas mayores y los LOS Neisseria niños pequeños

Patogénesis

Transmisión

• Garrapatas como vectores:
  • E. chaffeensis es transmitida por Amblyomma Amblyomma A genus of hardbacked ticks, in the family Ixodidae. It includes the lone star tick, Amblyomma americanum, and the Gulf Coast tick, Amblyomma maculatum, in the Americas. Amblyomma americanum is the primary vector of Ehrlichia chaffeensis and Ehrlichia ewingii which cause Ehrlichiosis. Other Amblyomma-associated diseases include tularemia and rickettsiosis. Rickettsia americanum (garrapata de la estrella solitaria).
  • A. phagocytophilum es transmitido por las garrapatas Ixodes.
• Iatrogénico (raro):
  • Transfusión de sangre
  • Trasplante de órganos sólidos

Reservorios

Una amplia gama de animales salvajes y domésticos pueden servir como reservorios. Los LOS Neisseria más destacados son:

• Ciervo de cola blanca (E. chaffeensis)
• Ratones de patas blancas (A. phagocytophilum)

Factores de virulencia

• Proteínas de superficie:
  • Permiten la unión a las células del huésped para la entrada
  • La variación antigénica ayuda a evadir el sistema inmunológico del huésped.
• Proteínas efectoras bacterianas:
  • Translocación a una célula huésped
  • Modifican el citoesqueleto de la célula para permitir la entrada de la bacteria Bacteria Bacteria are prokaryotic single-celled microorganisms that are metabolically active and divide by binary fission. Some of these organisms play a significant role in the pathogenesis of diseases. Bacteriology
  • Permiten que las vacuolas que contienen bacterias eviten la fusión de los LOS Neisseria lisosomas
  • Alteran la expresión génica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el núcleo de la célula huésped

Fisiopatología

Erliquiosis monocítica humana:

• E. chaffeensis es introducida en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la piel durante una picadura de garrapata.
• Infecta a los LOS Neisseria monocitos y macrófagos
• Se propaga a través de las vías linfáticas o la sangre a:
  • Médula ósea
  • Hígado
  • Ganglios linfáticos
  • Bazo
• La presentación clínica se debe a los LOS Neisseria efectos de la respuesta inflamatoria del huésped.

Anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana:

• A. phagocytophilum es introducida en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la piel durante una picadura de garrapata → reclutamiento de neutrófilos
• A. phagocytophilum entra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria neutrófilos:
  • Altera la muerte intracelular
  • Induce la activación de los LOS Neisseria neutrófilos y la liberación de citoquinas → contribuye a la lesión de los LOS Neisseria tejidos y a las manifestaciones clínicas
• La infección se propaga por vía hematógena.

Presentación Clínica

Signos y síntomas

El periodo de incubación suele ser 1–2 semanas, y la presentación clínica puede variar mucho.

Características de la erliquiosis monocítica humana y la anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana:

• Síntomas inespecíficos:
  • Fiebre
  • Malestar
  • Cefalea
  • Mialgia
  • Artralgia
• Síntomas gastrointestinales:
  • Dolor Dolor Inflammation abdominal
  • Náuseas
  • Vómitos
  • Diarrea
• Síntomas respiratorios:
  • Tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome
  • Dificultad para respirar

Hallazgos más comunes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum erliquiosis monocítica humana:

• Erupción:
  • Macular, maculopapular Maculopapular Dermatologic Examination o petequial
  • Más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños
• Síntomas neurológicos:
  • Cambio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el estado mental
  • Rigidez nucal
  • Clonus Clonus Ehrlichiosis and Anaplasmosis
  • Meningoencefalitis

Complicaciones

• Convulsiones
• Síndrome de distrés respiratorio agudo
• Miocarditis e insuficiencia cardíaca
• Derrame pericárdico y taponamiento
• Insuficiencia renal
• Coagulopatía
• Shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock séptico
• Linfohistiocitosis hemofagocítica (complicación poco común y grave de la anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana)
• Infecciones oportunistas

Diagnóstico y Tratamiento

Diagnóstico

Estudios definitivos:

• Pruebas de anticuerpo fluorescente indirecto
• Pruebas de anticuerpos por ensayo inmunoabsorbente ligado a enzimas ( ELISA ELISA An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. St. Louis Encephalitis Virus, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
• PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR) para detectar el ácido desoxirribonucleico (ADN) del organismo
• Examen de capa leucocitaria o frotis de sangre periférica: Se observan mórulas intracitoplasmáticas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria leucocitos de la sangre periférica.

Estudios de laboratorio de soporte:

• Trombocitopenia
• Leucopenia
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types
• ↑ Aspartato aminotransferasa ( AST AST Enzymes of the transferase class that catalyze the conversion of l-aspartate and 2-ketoglutarate to oxaloacetate and l-glutamate. Liver Function Tests) y alanina aminotransferasa ( ALT ALT An enzyme that catalyzes the conversion of l-alanine and 2-oxoglutarate to pyruvate and l-glutamate. Liver Function Tests)
• ↑ Fosfatasa alcalina
• ↑ Lactato deshidrogenasa
• ↑ Creatinina

Tratamiento

La doxiciclina es el antibiótico de elección.

• El tratamiento debe iniciarse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con sospecha de erliquiosis monocítica humana o anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana mientras se realizan las pruebas de laboratorio.
• Si los LOS Neisseria pacientes no mejoran con la terapia, deben ser evaluados para detectar una infección por Babesia Babesia Babesiosis is an infection caused by a protozoa belonging to the genus, Babesia. The most common Babesia seen in the United States is B. microti, which is transmitted by the Ixodes tick. The protozoa thrive and replicate within host erythrocytes. Lysis of erythrocytes and the body’s immune response result in clinical symptoms. Babesia/Babesiosis concurrente.

Prevención

Evitar las picaduras de garrapatas es la clave para prevenir estas enfermedades.

• Llevar ropa de protección adecuada
• Utilizar repelentes de garrapatas
• Inspección de garrapatas después de una actividad al AL Amyloidosis aire libre
• Eliminar cualquier garrapata adherida para reducir el riesgo de infección
• Control de garrapatas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum animales domésticos
• No se recomienda la profilaxis con doxiciclina después de una picadura de garrapata.

Comparación de las Bacterias Gram-negativas Transmitidas por Garrapatas

Diagnóstico Diferencial

• Babesiosis Babesiosis Babesiosis is an infection caused by a protozoa belonging to the genus, Babesia. The most common Babesia seen in the United States is B. microti, which is transmitted by the Ixodes tick. The protozoa thrive and replicate within host erythrocytes. Lysis of erythrocytes and the body’s immune response result in clinical symptoms. Babesia/Babesiosis: infección transmitida por garrapatas y causada por Babesia Babesia Babesiosis is an infection caused by a protozoa belonging to the genus, Babesia. The most common Babesia seen in the United States is B. microti, which is transmitted by the Ixodes tick. The protozoa thrive and replicate within host erythrocytes. Lysis of erythrocytes and the body’s immune response result in clinical symptoms. Babesia/Babesiosis. Los LOS Neisseria pacientes pueden ser asintomáticos o desarrollar fiebre, fatiga, malestar y artralgias. Los LOS Neisseria pacientes asplénicos, inmunocomprometidos y de edad avanzada corren el riesgo de padecer una enfermedad grave, causando anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types hemolítica, trombocitopenia, hepatoesplenomegalia, insuficiencia renal y muerte. El diagnóstico se confirma con un frotis de sangre periférica, pruebas serológicas y PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR). El tratamiento incluye antimicrobianos como la atovacuona más azitromicina.
• Fiebre de las Montañas Rocosas: enfermedad causada por Rickettsia rickettsii Rickettsia rickettsii A species of gram-negative, aerobic bacteria that is the etiologic agent of rocky mountain spotted fever. Its cells are slightly smaller and more uniform in size than those of rickettsia prowazekii. Rickettsia que cursa con fiebre, fatiga, cefalea y erupción tras la picadura de una garrapata. Sin embargo, esta enfermedad está asociada a la garrapata Dermacentor Dermacentor A widely distributed genus of ticks, in the family ixodidae, including a number that infest humans and other mammals. Several are vectors of diseases such as tularemia; rocky mountain spotted fever; colorado tick fever; and anaplasmosis. Rickettsia, y la erupción se presenta con más frecuencia que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la erliquiosis monocítica humana o la anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana. El diagnóstico se realiza con base en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las características clínicas, biopsia de la erupción y pruebas serológicas. El tratamiento incluye antibióticos, incluyendo la doxiciclina.
• Hepatitis vírica: inflamación del hígado causada por una infección por el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la hepatitis. Los LOS Neisseria pacientes pueden presentar un pródromo viral de fiebre, anorexia Anorexia The lack or loss of appetite accompanied by an aversion to food and the inability to eat. It is the defining characteristic of the disorder anorexia nervosa. Anorexia Nervosa y náuseas. También se produce dolor Dolor Inflammation abdominal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuadrante superior derecho, ictericia y transaminitis Transaminitis Tick-borne Encephalitis Virus. El diagnóstico se realiza con pruebas serológicas virales y diferenciará la hepatitis de la erliquiosis monocítica humana o la anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana. El tratamiento de la hepatitis aguda es de soporte.
• Mononucleosis Mononucleosis Infectious mononucleosis (IM), also known as “the kissing disease,” is a highly contagious viral infection caused by the Epstein-Barr virus. Its common name is derived from its main method of transmission: the spread of infected saliva via kissing. Clinical manifestations of IM include fever, tonsillar pharyngitis, and lymphadenopathy. Mononucleosis: enfermedad causada por el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de Epstein-Barr que se caracteriza por fiebre, fatiga, linfadenopatía y faringitis. Estas 2 últimas características se observan con menos frecuencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la erliquiosis monocítica humana o la anaplasmosis Anaplasmosis Anaplasmosis is a tick-borne bacterial infection. The most common causative species include Anaplasma phagocytophilum, which infect and multiply within granulocytes. The clinical presentation can vary widely, but often includes fever, malaise, headache, myalgia, and arthralgias. Ehrlichiosis and Anaplasmosis granulocítica humana. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las características clínicas y las pruebas, como la prueba de anticuerpos heterófilos o serología. El tratamiento es de soporte.
• Enfermedad de Lyme: infección causada por B. burgdorferi, que se transmite por la garrapata Ixodes. La presentación depende de la fase de la enfermedad y puede incluir una erupción eritematosa característica. Las manifestaciones neurológicas, cardíacas, oculares y articulares también son comunes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las etapas posteriores. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hallazgos clínicos y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la exposición a las garrapatas y es soportado por pruebas serológicas. Se utilizan antibióticos para el tratamiento.
• Brucelosis: infección causada por Brucella Brucella Brucellosis (also known as undulant fever, Mediterranean fever, or Malta fever) is a zoonotic infection that spreads predominantly through ingestion of unpasteurized dairy products or direct contact with infected animal products. Clinical manifestations include fever, arthralgias, malaise, lymphadenopathy, and hepatosplenomegaly. Brucella/Brucellosis, que se propaga principalmente tras la ingestión de productos lácteos no pasteurizados o el contacto directo con productos animales infectados. Las manifestaciones clínicas incluyen fiebre, artralgias, malestar, linfadenopatía y hepatoesplenomegalia. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las manifestaciones clínicas, antecedentes de exposición, serología y estudios de cultivo. El tratamiento implica una combinación de antibióticos, incluyendo doxiciclina, rifampicina y aminoglucósidos.