Human granulocytic ehrlichiosis in Connecticut: report of a fatal case.

Abstract

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 to 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.

• Authors: C J Hardalo, V Quagliarello, J S Dumler
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 21 Issue 4 Pg. 910-4 (Oct 1995) ISSN: 1058-4838 [Print] United States
• PMID: 8645839 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Bacterial

Topics

• Aged
• Antibodies, Bacterial (blood)
• Connecticut
• Ehrlichia (immunology)
• Ehrlichiosis (diagnosis, physiopathology)
• Fatal Outcome
• Fluorescent Antibody Technique
• Granulocytes (microbiology)
• Humans
• Male