Human granulocytic ehrlichiosis in Wisconsin and Minnesota: a frequent infection with the potential for persistence.
Human granulocytic ehrlichiosis (HGE) is a tickborne illness caused by an agent closely related to Ehrlichia equi and Ehrlichia phagocytophila. The clinical presentation is nonspecific, and diagnosis is made infrequently. Sixty-six sera were obtained from 54 patients in Minnesota and Wisconsin with undifferentiated fever during the summer and fall of 1993. Serologic reactivity with E. equi was observed in 6 (11%), including 4 seroconversions, 1 stable titer, and 1 seroreversion. Of the seropositive patients, HGE agent DNA was detected by polymerase chain reaction in the first serum from 4 of 5 patients and was present in the serum of 1 of 2 untreated patients after 21 days, even when E. equi antibodies also were present. HGE is a significant and potentially frequent cause of undifferentiated fever in Wisconsin and Minnesota during seasons with tick activity. The agent may persist in untreated patients for at least 1 months or may be cleared earlier, even if not treated with doxycycline or tetracycline.
Dumler
J S
JS
Department of Pathology, University of Maryland School of Medicine, Baltimore, 21287, USA.
Bakken
J S
JS
D000208:Acute Disease; D000907:Antibodies, Bacterial / Q000032:analysis; D002908:Chronic Disease; D004269:DNA, Bacterial / Q000032:analysis; D016873:Ehrlichiosis / Q000175:diagnosis / Q000453:epidemiology*; D006098:Granulocytes / Q000276:immunology*; D006801:Humans; D008910:Minnesota; D014922:Wisconsin
D000907:Antibodies, Bacterial; D004269:DNA, Bacterial