Ehrlychia is a co-infection of Lyme Disease which infects different kinds of white blood cells.  In HME (human monocytic ehrlichiosis), they infect monocytes.  In HGE (human granulocytic ehrlichiosis), they infect granulocytes.  Symptoms include sudden high fever, fatigue, muscle aches, and headache.  Severely ill patients can have low white blood cell count, low platelet count, anemia, elevated liver enzymes, kidney failure, and respiratory insufficiency.  Diagnosis is limited by the ability to test for only two species of bacteria.  Ehrlychia parasites multiple inside host cells, forming large mulberry-shaped clusters called morulae which are sometimes seen on blood smears, but are often missed.  Doctors may suspect ehrlichiosis/anaplasmosis in a patient who does not respond well to treatment for Lyme Disease

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