Human granulocytic ehrlichiosis: A case series from a medical center in New York State

Maria E. Aguero-Rosenfeld, Harold W. Horowitz, Gary P. Wormser, Donna F. McKenna, John Nowakowski, José Muñoz, J. Stephen Dumler

Research output: Contribution to journalArticlepeer-review

160 Scopus citations


Background: Human granulocytic ehrlichiosis (HGE) is a newly described illness with few reports in the literature. Objective: To describe the clinical and laboratory features of HGE. Design: Case series. Setting: Tertiary care facility in New York State. Patients: 18 adult patients with HGE. Measurements: Epidemiologic, clinical, and laboratory features; treatment; and outcome of patients with HGE. Results: Patients presented with such symptoms as fever (94%) and myalgia or arthralgia (78%). Thirteen patients (71%) recalled being bitten by a tick before onset of symptoms. Leukopenia or thrombocytopenia was seen in 82% of patients, and abnormal liver enzyme levels were seen in 81%. Results of polymerase chain reaction were positive in 9 of 12 patients (75%); morulae were seen in 3 of 12 patients (25%); and the agent that causes HGE was cultured from 2 patients. All but one patient (94%) developed antibodies to Ehrlichia equi. Five patients (28%) were briefly hospitalized, and none died. All patients were successfully treated with doxycycline. Conclusions: The illness associated with HGE in these patients from the northeastern United States was more mild than that originally described in reports of HGE in the midwestern United States.

Original languageEnglish (US)
Pages (from-to)904-908
Number of pages5
JournalAnnals of internal medicine
Issue number11
StatePublished - 1996

ASJC Scopus subject areas

  • Internal Medicine


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