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Case Reports
. 2025 Jul 9;17(7):e87581.
doi: 10.7759/cureus.87581. eCollection 2025 Jul.

Ehrlichiosis Manifesting as Septic Shock and Respiratory Failure With Alveolar Hemorrhage in an Immunocompetent Patient

Katherine R Sommers  1 , Ronald G Washburn  2
Affiliations
Case Reports

Ehrlichiosis Manifesting as Septic Shock and Respiratory Failure With Alveolar Hemorrhage in an Immunocompetent Patient

Katherine R Sommers et al. Cureus. .

Abstract

Ehrlichiosis is a bacterial infection transmitted through the bite of an infected lone star tick. The disease presents as a flu-like illness that is typically mild and self-limited. However, it can progress to severe disease with multiorgan involvement and numerous complications. We present a case of a 75-year-old immunocompetent female patient who developed septic shock and respiratory failure with alveolar hemorrhage after tick exposure. She was diagnosed with ehrlichiosis based on molecular testing via polymerase chain reaction (PCR) and completed a 10-day course of doxycycline with clinical improvement. Alveolar hemorrhage is a rare but serious complication of ehrlichiosis. This case emphasizes the importance of detailed history taking and the value of pattern recognition to facilitate timely diagnosis and treatment of ehrlichiosis, which is necessary for improved patient outcomes.

Keywords: alveolar hemorrhage; doxycycline; ehrlichia chaffeensis; ehrlichiosis; lone star tick.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Chest radiograph on day 1 of hospitalization demonstrated mild bilateral infiltrates.
Figure 2
Figure 2. Chest radiograph on day 10 of hospitalization showed progression of bilateral infiltrates with worsening pulmonary edema.
See this image and copyright information in PMC

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