Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the United States, 1988

Article Abstract:

Human ehrlichiosis is a potentially serious, even fatal, disease spread by ticks, found primarily in the south and southeastern regions of the United States. Ehrlichia are rickettsia, organisms with traits of both bacteria and viruses that live in lice, fleas, ticks, and mites. They are transmitted by the bites of these insects. Human ehrlichiosis causes a fever with headache, muscle aches, loss of appetite, nausea, vomiting, chills, and sometimes a rash. In laboratory tests, abnormally low white cell and platelet counts, and high hepatic aminotransferase (an enzyme) values are noted. Outcomes range from a complete lack of symptoms to death, but treatment with tetracycline or chloramphenicol seems to be equally effective in preventing complications if administered in time. Of 403 patients tested by the Centers for Disease Control (CDC), 34 tested positive, and of the 138 patients tested by the Oklahoma State Department of Health, six tested positive. In none of these patients was ehrlichiosis considered as the initial diagnosis, and was the final diagnosis in only 6 (18 percent), indicating a severe problem with recognition on the part of physicians. All patients had a fever, and most had headache, chills or shivering, malaise, nausea, muscle pain, and loss of appetite. Rash is less common than with Rocky Mountain spotted fever, but was present in almost half of the patients, primarily in young patients. Serious complications, especially breathing problems and brain dysfunction (encephalopathy), were common. Seven patients required intubation and mechanical ventilation, and three of the six patients with encephalopathy became comatose. Four had kidney failure, with two requiring dialysis. Older patients have more complications, and they are more severe. Tetracycline therapy was more often initiated in nonhospitalized patients during the first week of illness than in hospitalized patients. Early treatment is important in managing the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Demographic aspects, Tick-borne diseases, Southern United States, Southern states

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Serologic diagnosis of human ehrlichiosis using two Ehrlichia canis isolates

Article Abstract:

Rickettsia are a class of microorganisms that are similar to both parasites and viruses. They are responsible for a variety of diseases and are normally transmitted by arthropods (lice, fleas, ticks, mites). Ehrlichia canis is a rickettsia seen in dogs that causes fatal hemorrhaging. In 1986 this organism was implicated as a cause of ehrlichiosis in the US, but it has not been isolated from infected individuals. It has been isolated from infected dogs, however. The ability to isolate the organism from humans is important for cultivating an antigen that would permit the study of the disease in humans. Alternately, if a large enough supply of isolates could be gotten from dogs, research could progress as well. This has been difficult, however, because propagation of the organism obtained from dogs requires a continuous supply of blood from dogs, and lengthy processing. A technique has been developed whereby isolates of E. canis obtained from dogs can be cultured continuously for study; the method by which this was done is discussed. While it is not known if the organism is exactly the same as that found in humans, it is thought that its study will be applicable to the human ehrlichiosis as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research

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Human monocytic ehrlichiosis

Article Abstract:

Human monocytic ehrlichiosis (HME) is a disease that can cause severe infections or death but provides few specific clinical clues to diagnosis. It is stated that awareness of this disorder, recognition of its particular risk factors, and understanding the spectrum of known presentations and complications are critical to make the diagnosis promptly and to achieve a favorable outcome.

Risk factors

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