Peripheral blood smear
Obligate intracellular organism
Smear shows intracellular parasites only 20% of time
PCR
Most sensitive in first week of illness
Indirect Immunoflorescence Assay'
Gold Standard
Negative 85% of time in first 7 days of illness
Compare 2 samples drawn at different times
4 fold increase in titers of second draw is positive
Enzyme Immunoassay
Qualitative tests, not quantitative
Leukopenia, elevated transaminases, thrombocytopenia often present
Smear shows intracellular parasites only 20% of time
Most sensitive in first week of illness
Gold Standard
Negative 85% of time in first 7 days of illness
Compare 2 samples drawn at different times
4 fold increase in titers of second draw is positive
Qualitative tests, not quantitative
Ehrlichiosis
Babesiosis
Toxoplasmosis
Colorado tick fever
Malaria
Anthrax
Heartland virus
Viral hemorrhagic fevers