Ehrlichiosis is a nationally notifiable condition. Correct testing and reporting of ehrlichiosis are important to improve our understanding of how common this disease is, where it occurs, and how disease trends change over time.Testing for ehrlichiosis should be considered for any person with a compatible illness and known risk factors, such as history of a tick bite.The optimal diagnostic test may depend on the timing relative to symptom onset and the type of specimen(s) available for testing. Diagnostic tests should be performed on those with illness clinically compatible with ehrlichiosis.Treatment should not be delayed pending the receipt of laboratory test results or withheld based on an initial negative laboratory result. The diagnosis of ehrlichiosis is often made based on clinical signs and symptoms, and can later be confirmed using specialized laboratory tests. Laboratory confirmation is helpful for disease surveillance and understanding burden of ehrlichiosis infection in the United States.Advanced ehrlichiosis may also be confused clinically with non-tickborne illnesses such as meningoencephalitis, sepsis, toxic shock syndrome, gastroenteritis, hepatitis, and blood malignancies.Travel history (domestic and international) to areas where ehrlichiosis is endemic.Exposure to areas where ticks are commonly found, including wooded areas or brushy areas with high grasses and leaf litter. Do not rule out a tickborne infection if your patient does not remember a tick bite. Many people do not remember being bitten.
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