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Human ehrlichiosis and anaplasmosis can present with nonspecific signs and symptoms, potentially delaying diagnosis and appropriate treatment. Although death from untreated disease is uncommon, morbidity can be substantial. To assess the consequences of delayed treatment, investigators retrospectively examined the outcomes of patients who were admitted to a tertiary care hospital in St. Louis from 1996 through 2006 and had a diagnosis of ehrlichiosis. Diagnosis was based on having both a clinical presentation compatible with ehrlichiosis and a positive blood PCR test for Ehrlichia. Treatment was defined as delayed if doxycycline was not administered within 24 hours of admission.
Of 46 patients identified with ehrlichiosis, 28 (60.9%) had a d…