Cases reported "Ehrlichiosis"

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11/38. Reinfection with ehrlichia chaffeensis in a liver transplant recipient.

    Human monocytic ehrlichiosis is an emerging infection caused by ehrlichia chaffeensis, but reinfection with this agent has not been described. We report a case of reinfection with E. chaffeensis after a 2-year interval in a 56-year-old liver transplant recipient with frequent tick attachments.
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12/38. Human granulocytic ehrlichiosis in a renal allograft recipient: review of the clinical spectrum of disease in solid organ transplant patients.

    BACKGROUND: ehrlichiosis is a recently described zoonotic infection with two major expressions: human granulocytic ehrlichiosis (HGE) and human monocytic ehrlichiosis (HME). The organisms associated with HGE and HME have been detected in a tick vector in several regions of united states and cases of ehrlichiosis have been reported in the general population. methods: We report a case of HGE in a renal allograft recipient and review the clinical spectrum of disease in solid organ transplant recipients and the epidemiological basis for risk. RESULTS: Our patient demonstrated the typical epidemiological, clinical and laboratory features of human granulocytic ehrlichiosis and responded to treatment with doxycycline. CONCLUSIONS: Human ehrlichiosis should be considered in the differential diagnosis of patients with solid organ transplants, who present with fever and thrombocytopenia. The incidence of ehrlichiosis in the solid organ transplant population is similar to that in the united states general population. As reported in immunocompetent patients, prompt diagnosis and treatment results in the rapid resolution of symptoms in transplanted individuals.
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13/38. Simultaneous infection with borrelia burgdorferi and human granulocytic ehrlichiosis.

    A 5-year-old child with simultaneous early lyme disease and human granulocytic ehrlichiosis (HGE) is described. Because of the shared vector, HGE and lyme disease are increasingly identified as coinfections in tick-exposed patients. Early recognition of concurrent lyme disease and HGE is important because amoxicillin, an antibiotic of choice for young children with early lyme disease, is ineffective for HGE.
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14/38. First documented case of human granulocytic ehrlichiosis in austria.

    We report the first documented case of human granulocytic ehrlichiosis (HGE) in austria. The infection was acquired near Arzl in the surroundings of Innsbruck in northern Tyrol. Except for a biphasic course of illness, presentation in this 33-year-old female patient was comparable to clinical findings observed in other European adults with high fever, transient thrombocytopenia, elevated levels of CRP and LDH, arthralgias, myalgias, fatigue and subfebrile temperature. Flu-like symptoms started about seven days after a tick bite and lasted for ten days, followed by an asymptomatic interval of three days and an acute onset of fever up to 39.5 degrees C on day 20. On admission, the patient showed high antibody titres against anaplasma phagocytophilum (IgG 1:1024, IgM 1:640); six weeks later the IgG-titre had risen to 1:2048, and IgM-levels had fallen below 1:40. The demonstration of anti-platelet antibodies in acute-phase serum was noteworthy. We conclude that also in austria HGE should be considered in patients with febrile thrombocytopenia, especially when the medical history reveals recent tick exposure.
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15/38. Successful treatment of human granulocytic ehrlichiosis in children using rifampin.

    Human granulocytic ehrlichiosis (HGE) is an emerging tick-borne infectious disease caused by anaplasma phagocytophilum. Clinical features include a flu-like illness that usually resolves within 1 week. More serious infection may occur that requires hospital admission or culminates in death. doxycycline is the treatment of choice for HGE but may cause permanent staining of teeth in children younger than 8 years of age. We report successful treatment of HGE with rifampin in 2 children, 4 and 6 years old. A course of rifampin for 5 to 7 days should be considered in children younger than 8 years of age who experience non-life-threatening A phagocytophilum infection.
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16/38. Human ehrlichioses in brazil: first suspect cases.

    Brazilian spotted fever (BSF) rickettsiosis is the most common and recognized of the human rickettsioses in brazil. It is difficult to establish the diagnosis of human rickettsiosis infection by routine microbiologic methods, creating a false idea that rickettsia and Ehrlichia infections are rare and without importance. New tick-borne diseases, like human granulocytic anaplasmosis (HGA) and human monocytic ehrlichiosis (HME), have been described in many countries. These diseases can present symptoms similar to rickettsioses of the spotted fever group, and they are transmitted by ixodid ticks. The first two suspected cases of human ehrlichiosis in brazil were first considered to be cases of BSF. The differential diagnosis was made at the Minas Gerais Rickettsiosis public health Laboratory. The clinical and laboratory findings, with positive serology for the HME agent, indicated suspected cases of human ehrlichioses in brazil.
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17/38. Concomitant tickborne encephalitis and human granulocytic ehrlichiosis.

    We report a patient with febrile illness and epidemiologic and clinical findings consistent with human granulocytic ehrlichiosis and tickborne encephalitis, in whom infection with anaplasma phagocytophilum was demonstrated by polymerase chain reaction and seroconversion. Tickborne encephalitis virus infection was established by serum immunoglobulin (Ig) M and IgG antibodies.
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18/38. Isolation and characterization of an Ehrlichia sp. from a patient diagnosed with human ehrlichiosis.

    A new disease was recognized in the united states in 1986. The etiologic agent, although not previously isolated from a human, appeared to be serologically related to ehrlichia canis, a canine leukotropic rickettsia. We obtained blood specimens from 27 febrile patients with a history of tick exposure. leukocytes from 24 patients not treated with tetracycline were placed onto a monolayer of DH82 cells. We performed indirect immunofluorescence on sera from all 27 febrile patients as well as sera from 12 patients with previously diagnosed ehrlichiosis. Intractoplasmic inclusions were first observed in culture 35 days after the addition of infected blood from one patient. Partial sequencing of the rRNAs from the human isolate and E. canis indicated that they are 98.7% related. Positive indirect immunofluorescence reactions to the human isolate were obtained for all 12 previously diagnosed patients and for 33% of the 27 febrile patients. Two patients were seropositive for the human isolate but not for E. canis. No sera were positive for E. canis and negative for the human isolate. We report the isolation of a previously unrecognized Ehrlichia sp. that appears to be the etiologic agent of human ehrlichiosis. Serologic data (range of antibody titers, 256 to 32,768) in combination with rRNA sequencing indicated that the newly isolated Ehrlichia sp. is similar, but not identical, to E. canis.
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19/38. ixodes dammini as a potential vector of human granulocytic ehrlichiosis.

    Little is known about the epidemiology and mode of transmission of the agent of human granulocytic ehrlichiosis (HGE). Analyses of an engorged female ixodes dammini tick removed from an HGE patient and 101 field-collected I. dammini and dermacentor variabilis from three wisconsin counties for borrelia burgdorferi and Ehrlichia phagocytophila/Ehrlichia equi dna revealed that the patient tick and 7 of 68 I. dammini ticks from Washburn County collected in 1982 and 1991 were positive for ehrlichial dna; 10 ticks from the same collections were positive for B. burgdorferi. Two specimens (2.2%) were positive for both organisms. Serologic evidence for exposure to the agent of HGE or its relatives was detected in 3 of 25 lyme disease patients from the upper Midwest. These data argue that I. dammini is a common vector for transmission of both lyme disease and HGE.
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20/38. ehrlichiosis with pancytopenia and ARDS.

    As illustrated by the case described in this report, the possibility of ehrlichiosis should be considered in the differential diagnosis of sulfasalazine toxicity/drug fever and other febrile illnesses presenting with pancytopenia/leukopenia and pulmonary abnormalities, when patients have been exposed to known tick-infested areas. Furthermore, the possibility of delayed serologic confirmation of Ehrlichia infection should be integrated into the diagnostic process as well.
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