Human monocytic ehrlichiosis: An emerging pathogen in transplantation

Henkie P. Tan, J. Stephen Dumler, Warren R. Maley, Andrew S. Klein, James F. Burdick, F. Fred Poordad, Paul J. Thuluvath, Jay S. Markowitz

Research output: Contribution to journalArticle

Abstract

Background. The spectrum of disease caused by Ehrlichia spp. ranges from asymptomatic to fatal. Awareness and early diagnosis of the infection is paramount because appropriate therapy leads to rapid defervescence and cure. If left untreated, particularly in immunosuppressed patients, ehrlichioses may result in multi-system organ failure and death. Methods. We report the second case of human monocytic ehrlichiosis (HME) in a liver transplant recipient, and review the literature. Results. The patient presented with fever and headache, had negative cultures, and despite broad-spectrum antimicrobial coverage appeared progressively septic. After eliciting a history of tick exposure we treated the patient empirically with doxycycline. The diagnosis of HME was confirmed by 1) polymerase chain reaction (PCR) for Ehrlichia chaffeensis, 2) acute and convalescent serum titers, and 3) in vitro cultivation of E chaffeensis from peripheral blood. Conclusion. Although human ehrlichioses are relatively uncommon, they are emerging as clinically significant arthropod-borne infections. Although epidemiological exposure is responsible for infection, immunosuppression makes patients more likely to succumb to disease. A high index of suspicion and early treatment results in a favorable outcome.

Original languageEnglish (US)
Pages (from-to)1678-1680
Number of pages3
JournalTransplantation
Volume71
Issue number11
StatePublished - Jun 15 2001
Externally publishedYes

Fingerprint

Ehrlichiosis
Transplantation
Ehrlichia chaffeensis
Infection
Ehrlichia
Arthropods
Doxycycline
Ticks
Immunosuppression
Headache
Early Diagnosis
Fever
Polymerase Chain Reaction
Liver
Therapeutics
Serum

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Tan, H. P., Dumler, J. S., Maley, W. R., Klein, A. S., Burdick, J. F., Fred Poordad, F., ... Markowitz, J. S. (2001). Human monocytic ehrlichiosis: An emerging pathogen in transplantation. Transplantation, 71(11), 1678-1680.

Human monocytic ehrlichiosis : An emerging pathogen in transplantation. / Tan, Henkie P.; Dumler, J. Stephen; Maley, Warren R.; Klein, Andrew S.; Burdick, James F.; Fred Poordad, F.; Thuluvath, Paul J.; Markowitz, Jay S.

In: Transplantation, Vol. 71, No. 11, 15.06.2001, p. 1678-1680.

Research output: Contribution to journalArticle

Tan, HP, Dumler, JS, Maley, WR, Klein, AS, Burdick, JF, Fred Poordad, F, Thuluvath, PJ & Markowitz, JS 2001, 'Human monocytic ehrlichiosis: An emerging pathogen in transplantation', Transplantation, vol. 71, no. 11, pp. 1678-1680.
Tan HP, Dumler JS, Maley WR, Klein AS, Burdick JF, Fred Poordad F et al. Human monocytic ehrlichiosis: An emerging pathogen in transplantation. Transplantation. 2001 Jun 15;71(11):1678-1680.
Tan, Henkie P. ; Dumler, J. Stephen ; Maley, Warren R. ; Klein, Andrew S. ; Burdick, James F. ; Fred Poordad, F. ; Thuluvath, Paul J. ; Markowitz, Jay S. / Human monocytic ehrlichiosis : An emerging pathogen in transplantation. In: Transplantation. 2001 ; Vol. 71, No. 11. pp. 1678-1680.
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