Ehrlichia chaffeensis (Human Monocytic Ehrlichiosis = HME),
Anaplasma phagocytophilum (Human Granulocytic Ehrlichiosis = HGE) (gram-negative, obligatory intracellular in granulocytes)
Ixodes ricinus, Ixodes scapularis (deer tick)
game (e.g. deer), domestic animals, humans
rapid onset of beginning illness with fever, chills, headache and prostration, headaches are “sharp, knife-like and often located behind the eyes”, muscle pain, not joint pain, neurological symptoms, confusion, rarely diffuse vasculitic rash, including palms and soles (<10%), thromboctopenia, leukopenia, elevated liver enzymes
tick bites, older people, severe illnesses (e.g.: cancer), immune suppression (children).