This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Thomas R. Eng, VMD, MPH; John R. Harkess, MD; Daniel B. Fishbein, MD; Jacqueline E. Dawson, MS; Cornelia N. Greene; Martha A. Redus; F. T. Satalowich, DVM, MSPH

JAMA. 1990;264(17):2251-2258.

Abstract
In 1988, the Centers for Disease Control and the Oklahoma State Department of Health identified 40 patients who had a fourfold or greater change in antibody titer in response to Ehrlichia canis. The median age of these patients was 42 years, 83% were male, 76% became ill between May and July, and 92% reported recent exposures to ticks. Patients resided in or were exposed to ticks in 14 states, including five where ehrlichiosis had not been reported before 1988. Thirty-four patients (85%) were hospitalized, and many had serious complications, including acute respiratory failure (seven patients), encephalopathy (six patients), and acute renal failure (four patients). Pulmonary infiltrates were demonstrated in 14 patients, cerebrospinal fluid pleocytosis was seen in 10 patients, and elevated levels of serum creatinine were demonstrated in eight patients. Two patients, both of whom had preexisting medical problems, died. Nonhospitalized patients received tetracycline therapy earlier in the course of their illness than hospitalized patients. There was no significant difference in the interval from initiation of antibiotic therapy to the first day of defervescence between patients treated with tetracyclines and those treated with chloramphenicol.

(JAMA. 1990;264:2251-2258)

Author Affiliations
From the Division of Viral and Rickettsial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Ga (Drs Eng and Fishbein and Mss Dawson, Greene, and Redus); the Oklahoma State Department of Health, Oklahoma City (Dr Harkess); and the Missouri State Department of Health, Jefferson City (Dr Satalowich). Dr Eng is currently with the Office of Medical Services, Peace Corps, Washington, DC.

Footnotes
Presented in part at the Eighth Sesqui-annual Meeting of the American Society for Rickettsiology and Rickettsial Diseases, Diamond Point, NY, September 23. 1989, and at the 38th Annual Meeting of the American Society of Tropical Medicine and Hygiene, Honolulu, Hawaii, December 12, 1989.

Reprint requests to Viral and Rickettsial Zoonoses Branch, Centers for Disease Control, 1600 Clifton Rd, Mailstop G13, Atlanta, GA 30333 (Dr Fishbein).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Experimental infection of dairy calves with Ehrlichia chaffeensis
delos Santos et al.
J Med Microbiol 2007;56:1660-1668.
ABSTRACT | FULL TEXT  

Ehrlichia chaffeensis: a Prototypical Emerging Pathogen
Paddock and Childs
Clin. Microbiol. Rev. 2003;16:37-64.
ABSTRACT | FULL TEXT  

Ehrlichia chaffeensis Seroprevalence Among Children in the Southeast and South-Central Regions of the United States
Marshall et al.
Arch Pediatr Adolesc Med 2002;156:166-170.
ABSTRACT | FULL TEXT  

Serodiagnosis of Human Granulocytic Ehrlichiosis by Using Novel Combinations of Immunoreactive Recombinant Proteins
Lodes et al.
J. Clin. Microbiol. 2001;39:2466-2476.
ABSTRACT | FULL TEXT  

Animal Model of Fatal Human Monocytotropic Ehrlichiosis
Sotomayor et al.
Am. J. Pathol. 2001;158:757-769.
ABSTRACT | FULL TEXT  

Coinfection with Multiple Tick-Borne Pathogens in a Walker Hound Kennel in North Carolina
Kordick et al.
J. Clin. Microbiol. 1999;37:2631-2638.
ABSTRACT | FULL TEXT  

Tick-Borne Pulmonary Disease: Update on Diagnosis and Management
Faul et al.
Chest 1999;116:222-230.
ABSTRACT | FULL TEXT  

Serologic Testing for Human Granulocytic Ehrlichiosis at a National Referral Center
Comer et al.
J. Clin. Microbiol. 1999;37:558-564.
ABSTRACT | FULL TEXT  

Diagnosis of Human Ehrlichiosis by PCR Assay of Acute-Phase Serum
Comer et al.
J. Clin. Microbiol. 1999;37:31-34.
ABSTRACT | FULL TEXT  

Human Granulocytic Ehrlichiosis in New York
Wallace et al.
Arch Intern Med 1998;158:769-773.
ABSTRACT | FULL TEXT  

Immunodominant Major Outer Membrane Proteins of Ehrlichia chaffeensis Are Encoded by a Polymorphic Multigene Family
Ohashi et al.
Infect. Immun. 1998;66:132-139.
ABSTRACT | FULL TEXT  

Human Monocytic Ehrlichiosis in Children
Schutze and Jacobs
Pediatrics 1997;100:e10-e10.
ABSTRACT | FULL TEXT  

Human Ehrlichiosis--Maryland, 1994
JAMA 1996;276:1212-1213.
ABSTRACT  

The Interface Between Research and the Diagnosis of an Emerging Tick-borne Disease, Human Ehrlichiosis Due to Ehrlichia chaffeensis
Dawson et al.
Arch Intern Med 1996;156:137-142.
ABSTRACT  

Ehrlichiosis in a Golf-Oriented Retirement Community
Standaert et al.
NEJM 1995;333:420-425.
ABSTRACT | FULL TEXT  

Tick-Borne Diseases -- A Growing Risk
Fishbein and Dennis
NEJM 1995;333:452-453.
FULL TEXT  

Human Granulocytic Ehrlichiosis in the Upper Midwest United States: A New Species Emerging?
Bakken et al.
JAMA 1994;272:212-218.
ABSTRACT  

Fatal Seronegative Ehrlichiosis in a Patient with HIV Infection
Paddock et al.
NEJM 1993;329:1164-1167.
FULL TEXT  

Tick-Borne Diseases in the United States
Spach et al.
NEJM 1993;329:936-947.
FULL TEXT  

Infectious Diseases
Fisher and Douglas
JAMA 1991;265:3130-3132.
ABSTRACT