BACKGROUND: Human granulocytic ehrlichiosis (HGE) is a newly described illness with few reports in the literature. OBJECTIVE: To describe the clinical and laboratory feature of HGE. DESIGN: Case series. SETTING: Tertiary care facility in New York State. PATIENTS: 18 adult patients with HGE. MEASUREMENTS: Epidemiologic, clinical, and laboratory features; treatment; and outcome of patients with HGE. RESULTS: Patients presented with such symptoms as fever (94%) and myalgia or arthralgia (78%). Thirteen patients (71%) recalled being bitten by a tick before onset of symptoms. Leukopenia or thrombocytopenia was seen in 82% of patients, and abnormal liver enzyme levels were seen in 81%. Results of polymerase chain reaction were positive in 9 of 12 patients (75%); morulae were seen in 3 of 12 patients (25%); and the agent that causes HGE was cultured from 2 patients. All but one patient (94%) developed antibodies to Ehrlichia equi. Five patients (28%) were briefly hospitalized, and none died. All patients were successfully treated with doxycycline. CONCLUSIONS: The illness associated with HGE in these patients from the northeastern United States was more mild than that originally described in reports of HGE in the midwestern United States.
BACKGROUND:Humangranulocytic ehrlichiosis (HGE) is a newly described illness with few reports in the literature. OBJECTIVE: To describe the clinical and laboratory feature of HGE. DESIGN: Case series. SETTING: Tertiary care facility in New York State. PATIENTS: 18 adult patients with HGE. MEASUREMENTS: Epidemiologic, clinical, and laboratory features; treatment; and outcome of patients with HGE. RESULTS:Patients presented with such symptoms as fever (94%) and myalgia or arthralgia (78%). Thirteen patients (71%) recalled being bitten by a tick before onset of symptoms. Leukopenia or thrombocytopenia was seen in 82% of patients, and abnormal liver enzyme levels were seen in 81%. Results of polymerase chain reaction were positive in 9 of 12 patients (75%); morulae were seen in 3 of 12 patients (25%); and the agent that causes HGE was cultured from 2 patients. All but one patient (94%) developed antibodies to Ehrlichia equi. Five patients (28%) were briefly hospitalized, and none died. All patients were successfully treated with doxycycline. CONCLUSIONS: The illness associated with HGE in these patients from the northeastern United States was more mild than that originally described in reports of HGE in the midwestern United States.
Authors: M E Aguero-Rosenfeld; F Kalantarpour; M Baluch; H W Horowitz; D F McKenna; J T Raffalli; T c Hsieh; J Wu; J S Dumler; G P Wormser Journal: J Clin Microbiol Date: 2000-02 Impact factor: 5.948
Authors: G P Wormser; J Nowakowski; R B Nadelman; I Schwartz; D McKenna; D Holmgren; M Aguero-Rosenfeld Journal: Infection Date: 1998 Jul-Aug Impact factor: 3.553
Authors: M D Ravyn; J L Goodman; C B Kodner; D K Westad; L A Coleman; S M Engstrom; C M Nelson; R C Johnson Journal: J Clin Microbiol Date: 1998-06 Impact factor: 5.948