Diagnosis

Tick-borne infections are difficult to diagnose based solely on signs and symptoms because they are similar to many other common conditions. Therefore, a history of a known tick bite or possible exposure to ticks is an important piece of information in making a diagnosis. Your doctor will also conduct a physical exam and order tests.

If you have ehrlichiosis or anaplasmosis, the following results are likely found from blood tests:

  • Low count of white blood cells, which are disease-fighting cells of the immune system
  • Low count of blood platelet cells, which are essential for blood-clotting
  • Elevated liver enzymes that may indicate abnormal liver function

Tests of your blood may also indicate a tick-borne infection by detecting one of the following:

  • Specific genes unique to the bacteria
  • Antibodies to the bacteria created by your immune system

More Information

Treatment

If your doctor diagnoses ehrlichiosis or anaplasmosis — or suspects a diagnosis based on the symptoms and clinical findings — you'll begin treatment with the antibiotic doxycycline (Doryx, Vibramycin, others).

You'll take the drugs at least three days after you no longer have a fever and your doctor has observed improvement in other signs of disease. The minimum treatment is five to seven days. More serious illness may require two to three weeks of antibiotic treatment.

If you're pregnant or allergic to doxycycline, your doctor may prescribe the antibiotic rifampin (Rifadin, Rimactane, others).

Lifestyle and home remedies

If you find a tick on your body, don't be alarmed. Removing a tick promptly is a good defense against transmission of bacteria. Use the following steps:

  • Gloves. Wear medical gloves or similar gloves if possible to protect your hands.
  • Tweezers. Use fine-tipped tweezers to grab the tick firmly near its head or mouth, and as close to the skin as possible.
  • Removal. Pull the tick's body away your skin steadily and slowly without jerking or twisting it. If parts of the mouth remain, remove them with clean tweezers.
  • Disposal. Kill the tick by putting it in alcohol. Do not crush the tick to avoid exposure to possible bacteria. The dead tick can be flushed, lightly wrapped in tape before throwing in the trash or stored in a freezer.
  • Storage. A tick can be tested at a later date if you suspect infection. Place the tick in a container, label it with the date, and place it in the freezer.
  • Cleanup. Use soap and water to wash your hands after handling the tick and around the tick bite. Clean the site and your hands with rubbing alcohol.

Don't apply petroleum jelly, fingernail polish, rubbing alcohol or a hot match to the tick.

Monitor the bite site

A small, red bump, similar to the bump of a mosquito bite, often appears at the site of a tick bite or tick removal and resolves over a few days. This is normal and should not cause alarm.

If you experience continued irritation at the site or experience any signs or symptoms that may indicate a tick-borne infection, contact your doctor.

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 be referred to a doctor who specializes in infectious diseases.

If a tick-borne illness is possible because of recent outdoor activities, be prepared to address the following:

  • If you kept a removed tick, bring it to the appointment.
  • If you were bitten by a tick, when did it happen?
  • When were you possibly exposed to ticks?
  • Where have you been while doing outdoor activities?

Be prepared to answer these additional questions and write down the answers before your appointment.

  • What symptoms have you experienced?
  • When did they begin?
  • Has anything improved the symptoms or worsened them?
  • What medicines do you take regularly, including prescription and over-the-counter drugs, dietary supplements, herbal remedies, and vitamins?
  • Are you allergic to any medications, or do you have any other allergies?
Nov. 26, 2020
  1. Bennett JE, et al. Ticks, including tick paralysis. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Oct. 19, 2020.
  2. Goldman L, et al., eds. Rickettsial infections. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Oct. 19, 2020.
  3. Tickborne Diseases of the United States: A Reference Manual for Healthcare Providers. 5th ed. Centers for Disease Control and Prevention; 2018. http://www.cdc.gov/lyme/healthcare/clinicians.html. Accessed Oct. 19, 2020.
  4. Sexton DJ. Human ehrlichiosis and anaplasmosis. https://www.uptodate.com/contents/search. Accessed Oct. 19, 2020.
  5. Nelder MP, et al. Recent emergence of Anaplasma phagocytophilum in Ontario, Canada: Early serological and entomological indicators. American Journal of Tropical Medicine and Hygiene. 2019; doi:10.4269/ajtmh.19-0166.
  6. Tick removal and testing. Centers for Disease Control and Prevention. https://www.cdc.gov/lyme/removal/index.html. Accessed Oct. 19, 2020.
  7. Preventing tick bites on people. Centers for Disease Control and Prevention. https://www.cdc.gov/lyme/prev/on_people.html. Accessed Oct. 19, 2020.

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Ehrlichiosis and anaplasmosis