Anaplasmosis (granulocytes affected) or Ehrlichiosis (monocyte affected).

Gram negative, Infects WBC seen in buffy coat smears (in cytoplasm of granulocytes or Monocytes).
Multiply by binary fission in phagosomes and form mulberry shaped aggregates - Morulae

PCR available

Tick bite transmits- Ixodid, small sized. Disease in 5- 14 days

Fever with headache. Neutropenia, lymphopenia and thrombocytopenia, splenomegaly. Complications

like renal failure, respiratory failure, coagulopathy, myocarditis, encephalopathy, coma. Rash may occur
sometimes. Severe in immunocompromised hosts and mimic rocky mountain spotted fever which may
also co-exist.

(RMSF ticks are large sized, special clinical features with fever- has periorbital oedema, oedema of the
dorsum of the hand and feet and conjunctival congestion. There is a maculopapular /petechial rash of
RMSF on the wrist /ankle, neutropenia more in Ehrlichiosis than RMSF- in both lymphopenia,
thrombocytopenia, Transaminitis, atypical lymphocytes)

Treatment doxycycline for 10-14 days