Diagnosis

Tick-borne infections are difficult to diagnose based solely on signs and symptoms because the signs and symptoms, such as fever and muscle aches, are similar to many other common conditions.

Abnormal findings on a number of blood tests, combined with your history of possible exposure, may lead your doctor to suspect a tick-borne illness. If you have ehrlichiosis, your blood tests will likely show:

  • A low white blood cell count — these cells are the body's disease fighters
  • A low platelet count — platelets are essential to blood clotting
  • Abnormal liver function

More specific blood tests for ehrlichiosis include:

  • Polymerase chain reaction (PCR) test. This test helps identify specific genes unique to ehrlichiosis. However, if you've already started treatment, the results of this test may be affected.
  • Indirect fluorescent antibody (IFA) test. This test, not used as commonly as the PCR test, measures the amount of antibody you have in your blood to the bacteria that causes ehrlichiosis.

If you live in an area where ticks are common, your doctor may start you on antibiotics before the results of the blood tests return because earlier treatment results in a better outcome for some tick-borne diseases.

Treatment

If your doctor suspects that you have ehrlichiosis or another tick-borne illness, you'll likely receive a prescription for the antibiotic doxycycline (Doryx, Vibramycin, others). You'll generally take the antibiotic for up to 10 days. Your doctor may have you take antibiotics for a longer period if you're severely ill.

If you're pregnant, your doctor may prescribe the antibiotic rifampin (Rifadin, Rimactane) instead, because doxycycline isn't recommended during pregnancy.

Lifestyle and home remedies

If you find a tick on your body, don't be alarmed. If you remove the tick within 24 hours of its attachment, it's unlikely you'll get ehrlichiosis or other tick-borne illnesses. Follow these steps for safe removal of ticks:

  • Use tweezers if possible. Use a pair of flat-tipped tweezers or cover your hand with a tissue or glove to remove a tick. A tick's saliva and bodily fluids can carry the same bacterium that's found in its mouth and the bacterium can enter your body through cuts or mucous membranes in your skin.
  • Remove the tick slowly. Grab the tick by its mouth parts where it has attached to your skin. Pull it up and out of your skin steadily and slowly without jerking or twisting it.

    If you pull too quickly or grab the tick by its body, the tick will likely separate, leaving the mouth parts in your skin. If the tick's mouth parts do break off in your skin, remove them with tweezers.

    Petroleum jelly and hot matches are not effective treatments for removing ticks or tick parts from your skin. These methods may make matters worse by triggering the tick to release more of its bodily fluids, and that could cause further infection.

  • Kill the tick. Once you have successfully removed the tick, kill it by placing it in a container with rubbing alcohol in it. Don't crush the tick in your hands or with your fingernails because the fluids it releases may contain infected bacteria.

    If you want to save the tick for testing in the event you become ill, put it in a plastic bag or a jar, date the container and place it in the freezer.

  • Clean the bite site. Wash the bite site thoroughly with hand antiseptic or soap and water. And, thoroughly wash your hands.
  • Monitor the bite site. In the following days and weeks, watch the bite site for a rash and pay close attention to any signs and symptoms that develop such as fever, muscle aches or joint pain.

    If you notice anything out of the ordinary, see your doctor. If possible, bring the tick with you to your appointment.

Preparing for your appointment

You're likely to first see your primary care doctor or possibly an emergency room doctor, depending on the severity of your signs and symptoms. However, you may then be referred to a doctor who specializes in infectious diseases.

If you have time before your appointment to prepare, it's helpful to have certain information at hand. Here's what you can do to help get ready for your appointment, and what you can expect from your doctor.

What you can do

  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any recent travel to areas where ticks might be common.
  • Make a list of all medications, vitamins and supplements that you're taking, with dose information.
  • Write down questions to ask your doctor.

Preparing a list of questions can help you make the most of your time with your doctor. For erhlichiosis, some basic questions to ask your doctor include:

  • Did a tick bite cause these symptoms?
  • Are there other possible causes for my symptoms?
  • What tests do I need?
  • Does this infection have lasting effects?
  • What treatments are available, and which do you recommend?
  • What types of side effects can I expect from treatment?
  • I have another health problem. How can I best manage these conditions together?
  • Are there any alternatives to the primary approach you're suggesting?
  • Is there a generic alternative to the medicine you're prescribing?
  • What can I do to prevent this type of infection in the future?
  • Are there brochures or other printed material I can take with me? What websites do you recommend?

Don't hesitate to ask your doctor any other relevant questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • When did you begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • Have you traveled recently?
  • Have you been hiking, golfing or participating in other outdoor activities recently?
  • Have you found any ticks on you? If yes, when?
  • Have you had any problems with antibiotics in the past?
July 11, 2015
References
  1. Tickborne diseases of the United States — A reference manual for health care providers. Centers for Disease Control and Prevention. http://www.cdc.gov/lyme/healthcare/clinicians.html. Accessed June 10, 2015.
  2. Sexton DJ. Human ehrlichiosis and anaplasmosis. http://www.uptodate.com/home. Accessed June 10, 2015.
  3. Ferri FF. Ehrlichiosis and anaplasmosis. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. https://www.clinicalkey.com. Accessed June 10, 2015.
  4. Papadakis MA, et al., eds. Viral & rickettsial infections. In: Current Medical Diagnosis & Treatment 2015. 54th ed. New York, N.Y.: The McGraw-Hill Companies; 2015. http://www.accessmedicine.com. Accessed June 10, 2015.
  5. Lyme disease. American Lyme Disease Foundation. http://aldf.com/lyme-disease/#prevent. Accessed June 20, 2015.
  6. Preventing tick bites. Centers for Disease Control and Prevention. http://www.cdc.gov/lyme/prev/index.html. Accessed June 10, 2015.