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Infection With an Ehrlichia?

Daniel B. Fishbein, MD; Leigh A. Sawyer, DVM, MPH; Cynthia J. Holland, PhD; Edward B. Hayes, MD; Walter Okoroanyanwu, MD; David Williams, MD; R. Keith Sikes, DVM, MPH; Miodrag Ristic, DVM, PhD; Joseph E. McDade, PhD

JAMA. 1987;257(22):3100-3104.

Abstract
The Ehrlichia are tick-borne rickettsial organisms that cause disease in animals throughout the world but that have been previously recognized as human pathogens only in Asia. We have identified six patients with serological evidence of recent infection with an Ehrlichia: a fourfold or greater rise or fall in titer to Ehrlichia canis. All of the patients reported recent tick bites. Rigors, myalgia, headache, nausea, and anorexia were each reported by five patients. Fever was present in all patients and was accompanied by relative bradycardia and leukopenia in five patients, thrombocytopenia and abnormal liver function test results in four, and anemia in three. Five of the six patients were treated with tetracycline hydrochloride, and all recovered. Infection with Ehrlichia should be considered in patients with unexplained febrile illnesses after tick exposure.

(JAMA 1987;257:3100-3104)

Author Affiliations
From the Viral and Rickettsial Zoonoses Branch (Drs Fishbein, Sawyer, and McDade) and Epidemiology Office (Dr Hayes), Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta; Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana (Drs Holland and Ristic); Departments of Preventive Medicine and Public Health (Dr Okoroanyanwu) and Family Practice (Dr Williams), Morehouse School of Medicine, Atlanta; and Georgia Department of Human Resources, Atlanta (Dr Sikes).

Footnotes
Reprint requests to Viral and Rickettsial Zoonoses Branch, Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Fishbein).

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