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

M. E. Aguero-Rosenfeld, H. W. Horowitz, G. P. Wormser, D. F. McKenna, J. Nowakowski, J. Munoz, J. S. Dumler

Research output: Contribution to journalArticle

Abstract

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 n 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
Volume125
Issue number11
StatePublished - 1996
Externally publishedYes

Fingerprint

Ehrlichiosis
Epidemiologic Measurements
Midwestern United States
Anaplasma phagocytophilum
Morula
New England
Doxycycline
Myalgia
Leukopenia
Arthralgia
Ticks
Tertiary Healthcare
Thrombocytopenia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Aguero-Rosenfeld, M. E., Horowitz, H. W., Wormser, G. P., McKenna, D. F., Nowakowski, J., Munoz, J., & Dumler, J. S. (1996). Human granulocytic ehrlichiosis: A case series from a medical center in New York state. Annals of Internal Medicine, 125(11), 904-908.

Human granulocytic ehrlichiosis : A case series from a medical center in New York state. / Aguero-Rosenfeld, M. E.; Horowitz, H. W.; Wormser, G. P.; McKenna, D. F.; Nowakowski, J.; Munoz, J.; Dumler, J. S.

In: Annals of Internal Medicine, Vol. 125, No. 11, 1996, p. 904-908.

Research output: Contribution to journalArticle

Aguero-Rosenfeld, ME, Horowitz, HW, Wormser, GP, McKenna, DF, Nowakowski, J, Munoz, J & Dumler, JS 1996, 'Human granulocytic ehrlichiosis: A case series from a medical center in New York state', Annals of Internal Medicine, vol. 125, no. 11, pp. 904-908.
Aguero-Rosenfeld ME, Horowitz HW, Wormser GP, McKenna DF, Nowakowski J, Munoz J et al. Human granulocytic ehrlichiosis: A case series from a medical center in New York state. Annals of Internal Medicine. 1996;125(11):904-908.
Aguero-Rosenfeld, M. E. ; Horowitz, H. W. ; Wormser, G. P. ; McKenna, D. F. ; Nowakowski, J. ; Munoz, J. ; Dumler, J. S. / Human granulocytic ehrlichiosis : A case series from a medical center in New York state. In: Annals of Internal Medicine. 1996 ; Vol. 125, No. 11. pp. 904-908.
@article{ff7f7f75cbf04e29a0547e3762de0d35,
title = "Human granulocytic ehrlichiosis: A case series from a medical center in New York state",
abstract = "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 n 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.",
author = "Aguero-Rosenfeld, {M. E.} and Horowitz, {H. W.} and Wormser, {G. P.} and McKenna, {D. F.} and J. Nowakowski and J. Munoz and Dumler, {J. S.}",
year = "1996",
language = "English (US)",
volume = "125",
pages = "904--908",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "11",

}

TY - JOUR

T1 - Human granulocytic ehrlichiosis

T2 - A case series from a medical center in New York state

AU - Aguero-Rosenfeld, M. E.

AU - Horowitz, H. W.

AU - Wormser, G. P.

AU - McKenna, D. F.

AU - Nowakowski, J.

AU - Munoz, J.

AU - Dumler, J. S.

PY - 1996

Y1 - 1996

N2 - 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 n 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.

AB - 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 n 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.

UR - http://www.scopus.com/inward/record.url?scp=0030318672&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030318672&partnerID=8YFLogxK

M3 - Article

C2 - 8967671

AN - SCOPUS:0030318672

VL - 125

SP - 904

EP - 908

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 11

ER -