HUMAN GRANULOCYTIC EHRLICHIOSIS IN CONNECTICUT - REPORT OF A FATAL CASE

被引:103
作者
HARDALO, CJ
QUAGLIARELLO, V
DUMLER, JS
机构
[1] UNIV MARYLAND,SCH MED,MED CTR,DEPT PATHOL,BALTIMORE,MD 21201
[2] MORRISTOWN MEM HOSP,DEPT INTERNAL MED,MORRISTOWN,NJ
[3] YALE UNIV,SCH MED,DEPT INTERNAL MED,NEW HAVEN,CT 06510
关键词
D O I
10.1093/clinids/21.4.910
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
We report a case of granulocytic ehrlichiosis in a 71-year-old man who presented with an acute febrile illness and subsequently developed multisystem organ dysfunction and sudden severe anemia with thrombocytopenia requiring intensive care, mechanical ventilation, hemodialysis, and transfusions. The diagnosis was suspected on the fifth hospital day after a peripheral blood smear was examined; intracytoplasmic inclusion bodies were present in granulocytes only. Results of serological tests of acute and convalescent sera confirmed the diagnosis of granulocytic ehrlichiosis. We discuss the features of this case that were similar to those of published case reports as well as the course and outcome of treatment. This, to our knowledge, represents the first documented case of human granulocytic ehrlichiosis to occur outside the Upper Midwest, Because of the possible epidemiological association of Ehrlichia species with the deer tick Ixodes scapularis (dammini), this case raises additional concern for clinicians and patients in regions where Lyme disease is endemic.
引用
收藏
页码:910 / 914
页数:5
相关论文
共 24 条
  • [1] HUMAN GRANULOCYTIC EHRLICHIOSIS IN THE UPPER MIDWEST UNITED-STATES - A NEW SPECIES EMERGING
    BAKKEN, JS
    DUMLER, JS
    CHEN, SM
    ECKMAN, MR
    VANETTA, LL
    WALKER, DH
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 272 (03): : 212 - 218
  • [2] INVITRO ANTIBIOTIC SUSCEPTIBILITY OF THE NEWLY RECOGNIZED AGENT OF EHRLICHIOSIS IN HUMANS, EHRLICHIA-CHAFFEENSIS
    BROUQUI, P
    RAOULT, D
    [J]. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1992, 36 (12) : 2799 - 2803
  • [3] IDENTIFICATION OF A GRANULOCYTOTROPIC EHRLICHIA SPECIES AS THE ETIOLOGIC AGENT OF HUMAN-DISEASE
    CHEN, SM
    DUMLER, JS
    BAKKEN, JS
    WALKER, DH
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 1994, 32 (03) : 589 - 595
  • [4] DIAGNOSIS OF HUMAN EHRLICHIOSIS WITH THE INDIRECT FLUORESCENT-ANTIBODY TEST - KINETICS AND SPECIFICITY
    DAWSON, JE
    FISHBEIN, DB
    ENG, TR
    REDUS, MA
    GREENE, NR
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1990, 162 (01) : 91 - 95
  • [5] SEROLOGIC DIAGNOSIS OF HUMAN EHRLICHIOSIS USING 2 EHRLICHIA-CANIS ISOLATES
    DAWSON, JE
    RIKIHISA, Y
    EWING, SA
    FISHBEIN, DB
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1991, 163 (03) : 564 - 567
  • [6] DONATIEN A., 1935, Bulletin de la Societe de Pathologie Exotique, V28, P418
  • [7] DUMLER JS, 1993, HUM PATHOL, V24, P391
  • [8] PERSISTENT INFECTION WITH EHRLICHIA-CHAFFEENSIS
    DUMLER, JS
    SUTKER, WL
    WALKER, DH
    [J]. CLINICAL INFECTIOUS DISEASES, 1993, 17 (05) : 903 - 905
  • [9] DUMLER JS, IN PRESS J CLIN MICR
  • [10] IDENTIFICATION OF EHRLICHIA-CHAFFEENSIS MORULAE IN CEREBROSPINAL-FLUID MONONUCLEAR-CELLS
    DUNN, BE
    MONSON, TP
    DUMLER, JS
    MORRIS, CC
    WESTBROOK, AB
    DUNCAN, JL
    DAWSON, JE
    SIMS, KG
    ANDERSON, BE
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 1992, 30 (08) : 2207 - 2210