Human granulocytic ehrlichiosis: A case series from a medical center in New York state

被引:152
作者
AgueroRosenfeld, ME
Horowitz, HW
Wormser, GP
McKenna, DF
Nowakowski, J
Munoz, J
Dumler, JS
机构
[1] Clinical Laboratories, Westchester County Medical Center, Valhalla
[2] Division of Infectious Diseases, Westchester County Medical Center, Macy Pavilion 209 SE, Valhalla
[3] Main Nursing Office, Westchester County Medical Center, Valhalla
[4] New York Medical College, Department of Pediatrics, Munger Pavilion, Valhalla
[5] Division of Medical Microbiology, Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21287
关键词
D O I
10.7326/0003-4819-125-11-199612010-00006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Human granulocytic ehrlichiosis (HGE) is a newly described illness Objective: To describe the clinical and laboratory features of Design: Case series. Setting: Tertiary care facility in New York State. Patients: is 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.
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收藏
页码:904 / 908
页数:5
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