title: Diagnosis of human ehrlichiosis by PCR assay of acute-phase serum.
abstract: A PCR assay of 43 acute-phase serum samples was evaluated as a method for early detection of human granulocytic ehrlichiosis (HGE) and determination of etiology when serologic testing is inconclusive. Sequence-confirmed products of the HGE agent were amplified from three individuals residing or having exposure history in Minnesota or Wisconsin, and similarly confirmed products from Ehrlichia chaffeensis were amplified from three individuals from Florida or Maryland. Etiology, as determined by PCR and serology, was the same whenever there was a fourfold difference between the maximum titers of antibodies to both antigens, indicating that presumptive determination of etiology may be based on fourfold differences in titers. PCR testing determined that E. chaffeensis was the etiologic agent for one individual who had similar titers of antibodies to both agents. PCR assay of acute-phase serum in the absence of whole blood specimens may be a useful method for early detection of human ehrlichiosis and determination of etiology when serologic testing is inconclusive.
authors.affiliation: Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia 30333, USA. jnc0@cdc.gov
authors.forename: J A
authors.initials: JA
authors.lastname: Comer
authors.forename: W L
authors.initials: WL
authors.lastname: Nicholson
authors.forename: J W
authors.initials: JW
authors.lastname: Sumner
authors.forename: J G
authors.initials: JG
authors.lastname: Olson
authors.forename: J E
authors.initials: JE
authors.lastname: Childs
mesh_terms: D000210:Acute-Phase Reaction / Q000097:blood; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D018469:Ehrlichia chaffeensis / Q000235:genetics / Q000302:isolation & purification*; D016873:Ehrlichiosis / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D016133:Polymerase Chain Reaction / Q000379:methods*; D012336:RNA, Ribosomal, 16S / Q000032:analysis / Q000235:genetics
chemical_list: D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S