Identification of Ehrlichia chaffeensis morulae in cerebrospinal fluid mononuclear cells

B. E. Dunn, T. P. Monson, J. S. Dumler, C. C. Morris, A. B. Westbrook, J. L. Duncan, J. E. Dawson, K. G. Sims, B. E. Anderson

Research output: Contribution to journalArticle

Abstract

We report a case of ehrlichiosis in a 72-year-old man who developed extreme lethargy, acute renal failure requiring hemodialysis, and respiratory insufficiency requiring intubation. Lumbar puncture performed on the second day of hospitalization revealed significant cellular pleocytosis. Ehrlichia morulae were tentatively identified in mononuclear cells in routinely processed Wright-stained cytospin preparations of cerebrospinal fluid (CSF). Identification was confirmed by a specific immunocytochemical staining procedure. Subsequent identification specifically as Ehrlichia chaffeensis morulae was established by polymerase chain reaction analysis, which revealed E. chaffeensis-specific DNA in CSF, bone marrow, and blood samples; by indirect fluorescent-antibody analysis, the patient developed an antibody titer of 32,768 against E. chaffeensis antigen. The patient responded to intravenous therapy with doxycycline and dexamethasone. Subsequently, neurologic, hematologic, renal, and pulmonary status had returned to baseline at follow-up 12 weeks after admission. To our knowledge, this is the first identification of E. chaffeensis morulae in CSF cells in an infected patient.

Original languageEnglish (US)
Pages (from-to)2207-2210
Number of pages4
JournalJournal of Clinical Microbiology
Volume30
Issue number8
StatePublished - 1992
Externally publishedYes

Fingerprint

Ehrlichia chaffeensis
Morula
Cerebrospinal Fluid
Ehrlichia
Ehrlichiosis
Lethargy
Spinal Puncture
Antibodies
Doxycycline
Leukocytosis
Acute Kidney Injury
Intubation
Respiratory Insufficiency
Dexamethasone
Nervous System
Renal Dialysis
Hospitalization
Bone Marrow
Staining and Labeling
Kidney

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

Cite this

Dunn, B. E., Monson, T. P., Dumler, J. S., Morris, C. C., Westbrook, A. B., Duncan, J. L., ... Anderson, B. E. (1992). Identification of Ehrlichia chaffeensis morulae in cerebrospinal fluid mononuclear cells. Journal of Clinical Microbiology, 30(8), 2207-2210.

Identification of Ehrlichia chaffeensis morulae in cerebrospinal fluid mononuclear cells. / Dunn, B. E.; Monson, T. P.; Dumler, J. S.; Morris, C. C.; Westbrook, A. B.; Duncan, J. L.; Dawson, J. E.; Sims, K. G.; Anderson, B. E.

In: Journal of Clinical Microbiology, Vol. 30, No. 8, 1992, p. 2207-2210.

Research output: Contribution to journalArticle

Dunn, BE, Monson, TP, Dumler, JS, Morris, CC, Westbrook, AB, Duncan, JL, Dawson, JE, Sims, KG & Anderson, BE 1992, 'Identification of Ehrlichia chaffeensis morulae in cerebrospinal fluid mononuclear cells', Journal of Clinical Microbiology, vol. 30, no. 8, pp. 2207-2210.
Dunn BE, Monson TP, Dumler JS, Morris CC, Westbrook AB, Duncan JL et al. Identification of Ehrlichia chaffeensis morulae in cerebrospinal fluid mononuclear cells. Journal of Clinical Microbiology. 1992;30(8):2207-2210.
Dunn, B. E. ; Monson, T. P. ; Dumler, J. S. ; Morris, C. C. ; Westbrook, A. B. ; Duncan, J. L. ; Dawson, J. E. ; Sims, K. G. ; Anderson, B. E. / Identification of Ehrlichia chaffeensis morulae in cerebrospinal fluid mononuclear cells. In: Journal of Clinical Microbiology. 1992 ; Vol. 30, No. 8. pp. 2207-2210.
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