21/22. Human granulocytic ehrlichiosis in europe: clinical and laboratory findings for four patients from slovenia.Febrile illnesses following a tick bite in patients from slovenia were evaluated for an ehrlichial etiology. A case of acute human granulocytic ehrlichiosis (HGE) was confirmed by seroconversion to the HGE agent or molecular identification of ehrlichial organisms. Acute infection with the HGE agent was confirmed in four patients. None of the patients had detectable antibodies to the HGE agent at their first visit, but polymerase chain reaction analysis was positive for three patients. All four patients subsequently seroconverted to the HGE agent as shown by high titers of antibody. Clinical features and laboratory findings were similar to those in reports from the united states, although the disease course was relatively mild in the Slovenian cases. All patients recovered rapidly and without sequelae, although only two received antibiotic therapy (of whom only one was treated with doxycycline). HGE is an emerging tick-borne disease in the united states and should now be included in the differential diagnosis of febrile illnesses occurring after a tick bite in europe.- - - - - - - - - - ranking = 1keywords = lyme (Clic here for more details about this article) |
22/22. Fatal pancarditis associated with human granulocytic ehrlichiosis in a 44-year-old man.Human cases of infection with a granulocytotropic ehrlichia species closely related to ehrlichia equi are now being described with increasing frequency in the united states, especially in areas where lyme disease is already endemic. We describe a case of fatal pancarditis during the course of human granulocytic ehrlichiosis (HGE) in a 44-year-old outdoor worker who was previously treated for presumptive lyme disease. Serological and molecular diagnostic tests for borrelia burgdorferi and babesia microti infections were negative. Postmortem serum specimens were seroreactive for HGE, and molecular evidence of infection with the HGE agent was obtained. These findings suggest that carditis may be a manifestation of HGE, further complicating the differential diagnosis of tick-borne illness.- - - - - - - - - - ranking = 74.404833410047keywords = burgdorferi (Clic here for more details about this article) |
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