title: Human granulocytic ehrlichiosis: a case series from a medical center in New York State.
abstract: BACKGROUND
  Human granulocytic ehrlichiosis (HGE) is a newly described illness with few reports in the literature.
  
  
  OBJECTIVE
  To describe the clinical and laboratory feature of HGE.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Tertiary care facility in New York State.
  
  
  METHODS
  18 adult patients with HGE.
  
  
  METHODS
  Epidemiologic, clinical, and laboratory features; treatment; and outcome of patients with HGE.
  
  
  RESULTS
  Patients presented with such symptoms as fever (94%) and myalgia or arthralgia (78%). Thirteen patients (71%) recalled being bitten by a tick before onset of symptoms. Leukopenia or thrombocytopenia was seen in 82% of patients, and abnormal liver enzyme levels were seen in 81%. Results of polymerase chain reaction were positive in 9 of 12 patients (75%); morulae were seen in 3 of 12 patients (25%); and the agent that causes HGE was cultured from 2 patients. All but one patient (94%) developed antibodies to Ehrlichia equi. Five patients (28%) were briefly hospitalized, and none died. All patients were successfully treated with doxycycline.
  
  
  CONCLUSIONS
  The illness associated with HGE in these patients from the northeastern United States was more mild than that originally described in reports of HGE in the midwestern United States.
authors.affiliation: New York Medical College, Valhalla, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Aguero-Rosenfeld
authors.forename: H W
authors.initials: HW
authors.lastname: Horowitz
authors.forename: G P
authors.initials: GP
authors.lastname: Wormser
authors.forename: D F
authors.initials: DF
authors.lastname: McKenna
authors.forename: J
authors.initials: J
authors.lastname: Nowakowski
authors.forename: J
authors.initials: J
authors.lastname: Muñoz
authors.forename: J S
authors.initials: JS
authors.lastname: Dumler
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D016873:Ehrlichiosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006098:Granulocytes / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline