Clinical manifestations of ehrlichiosis usually begin 5-14 days after the tick bite. Approximately 68% of patients with human monocytic ehrlichiosis (HME) report a tick bite, and 83% of patients have a history of tick exposure in the 4-week period before onset of symptoms. Onset is abrupt or subacute.
Tick bites or exposure (>90%)
Rash is rare in patients with HME/HGA. Rash is rare but, if present, usually occurs on the trunk, legs, arms, or face and may be macular, maculopapular, and/or petechial.
Physical findings due to ehrlichiosis are minimal.
Splenomegaly is not uncommon, but some patients develop hepatomegaly. Lymphadenopathy is very uncommon. Patients with severe ehrlichiosis may develop thrombocytopenia.
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