1/9. Identification of ehrlichia chaffeensis morulae in cerebrospinal fluid mononuclear cells.We report a case of ehrlichiosis in a 72-year-old man who developed extreme lethargy, acute renal failure requiring hemodialysis, and respiratory insufficiency requiring intubation. Lumbar puncture performed on the second day of hospitalization revealed significant cellular pleocytosis. Ehrlichia morulae were tentatively identified in mononuclear cells in routinely processed Wright-stained cytospin preparations of cerebrospinal fluid (CSF). Identification was confirmed by a specific immunocytochemical staining procedure. Subsequent identification specifically as ehrlichia chaffeensis morulae was established by polymerase chain reaction analysis, which revealed E. chaffeensis-specific dna in CSF, bone marrow, and blood samples; by indirect fluorescent-antibody analysis, the patient developed an antibody titer of 32,768 against E. chaffeensis antigen. The patient responded to intravenous therapy with doxycycline and dexamethasone. Subsequently, neurologic, hematologic, renal, and pulmonary status had returned to baseline at follow-up 12 weeks after admission. To our knowledge, this is the first identification of E. chaffeensis morulae in CSF cells in an infected patient.- - - - - - - - - - ranking = 1keywords = ehrlichiosis (Clic here for more details about this article) |
2/9. Human ehrlichiosis: a newly recognized tick-borne disease.Human ehrlichiosis was first described in the United States in 1986. Since then, more than 215 cases have been reported, including some fatalities. Ehrlichia species belong to the same family as the organism that causes rocky mountain spotted fever. Human ehrlichiosis occurs most frequently in the southern mid-Atlantic and south-central states, during spring and summer months. The clinical presentation is similar to that seen in rocky mountain spotted fever although, with ehrlichiosis, leukopenia is more often found and skin rash is less often noted. Definitive diagnosis is based on acute and convalescent serum antibody titers. ehrlichiosis cannot reliably be distinguished from other common febrile illnesses on the basis of clinical, epidemiologic or laboratory features. Therapy must be initiated empirically in suspected cases. Both ehrlichiosis and rocky mountain spotted fever respond well to tetracycline and chloramphenicol, but not to penicillins or cephalosporins.- - - - - - - - - - ranking = 8keywords = ehrlichiosis (Clic here for more details about this article) |
3/9. infection due to ehrlichia canis in children.Human ehrlichiosis has a wide spectrum of presentation. This report presents two cases that demonstrate the diversity of the manifestation of ehrlichiosis, from life threatening to a mild viral-like illness. diagnosis requires an understanding of the epidemiology and clinical manifestation of this infection and a high index of suspicion.- - - - - - - - - - ranking = 2keywords = ehrlichiosis (Clic here for more details about this article) |
4/9. Human ehrlichiosis diagnosed in wisconsin.A man developed a febrile illness shortly after he returned to wisconsin from florida, where he had received tick bites. This illness was associated with a rash, thrombocytopenia, leukopenia, and elevated hepatic enzymes, and it resolved on doxycycline. Serologic studies confirmed ehrlichiosis, a tick-borne rickettsial intraleukocytic infection endemic to the southeastern united states. This case expands the spectrum of tick-borne illnesses that must be considered by wisconsin clinicians.- - - - - - - - - - ranking = 5keywords = ehrlichiosis (Clic here for more details about this article) |
5/9. ehrlichiosis in children.Tick-borne rickettsiae of the genus Ehrlichia have recently been recognized as a cause of human illness in the United States. In the years 1986-1988, 10 cases of ehrlichiosis were diagnosed in children in oklahoma. Fever and headache were universal: myalgias, nausea, vomiting, and anorexia were also common. Rash was observed in six patients but was a prominent finding in only one. leukopenia, lymphopenia, and thrombocytopenia were common laboratory abnormalities. Six patients were treated with tetracycline, three with chloramphenicol, and one was not treated with antibiotics: all recovered. The onset of illness in spring and early summer for most cases paralleled the time when Amblyomma americanum and dermacentor variabilis are most active, suggesting that one or both ticks may be vectors of human ehrlichiosis in oklahoma.- - - - - - - - - - ranking = 2keywords = ehrlichiosis (Clic here for more details about this article) |
6/9. Human ehrlichiosis: a rickettsial disease associated with severe cholestasis and multisystemic disease.We report an unusual case of a typically canine rickettsial disease, ehrlichiosis, in a 56-year-old man. Although only occasionally affecting humans with a mild illness, exposure to a tick bite in our patient led to severe multisystemic disease with intense cholestasis. coma, acute renal failure and respiratory failure requiring mechanical ventilation ensued. Imaging procedures showed no biliary obstruction. A liver biopsy demonstrated bile stasis and sinusoidal lymphoid infiltrates. The diagnosis was confirmed serologically. Only partial improvement occurred with tetracycline therapy, but total resolution of all abnormalities eventually followed therapy with chloramphenicol.- - - - - - - - - - ranking = 5keywords = ehrlichiosis (Clic here for more details about this article) |
7/9. Failure to transmit ehrlichia canis (Rickettsiales: Ehrlichieae) with Otobius megnini (acari: argasidae).An ear tick, Otobius megnini (Duges) recovered from a child who had serologic evidence of ehrlichiosis, was examined for Ehrlichia species microscopically and by inoculation into a susceptible dog; no evidence of infection was found in the tick. Experimental transmission of E. canis by laboratory-reared O. megnini was attempted; neither transstadial nor transovarial transmission occurred.- - - - - - - - - - ranking = 1keywords = ehrlichiosis (Clic here for more details about this article) |
8/9. Neurologic abnormalities in a patient with human ehrlichiosis.Human ehrlichiosis is a tick-borne rickettsial disease characterized by fever, headache, myalgias, anorexia, and occasionally rash. In our patient, changes in mental status, upper motor neuron signs, cerebrospinal fluid pleocytosis, and increased serum protein levels were found in association with serologically confirmed ehrlichiosis and were most likely due to vasculitis involving the central nervous system. Intraleukocytic inclusions, although observed in our case, have been infrequently found in other reported cases of ehrlichiosis.- - - - - - - - - - ranking = 7keywords = ehrlichiosis (Clic here for more details about this article) |
9/9. Human ehrlichiosis.ehrlichiosis is one of the latest tick-borne illnesses to be reported in humans. The authors describe two cases of this rickettsial disease that were apparently acquired in missouri. They discuss diagnosis and treatment.- - - - - - - - - - ranking = 4keywords = ehrlichiosis (Clic here for more details about this article) |