Human ehrlichiosis in central Europe.
Ehrlichioses are tick-transmitted diseases associated with illnesses of animals for decades, but recently recognised to be emerging human diseases. In the last ten years increasing number of cases of human infections caused by Ehrlichia chaffeensis and granulo-cytic ehrlichia were described in the United States. Several reports also indicate the presence of infection with the human granulocytic ehrlichiosis (HGE) agent in Europe. The first confirmed acute human disease caused by HGE agent was reported from Slovenia. Until 1997, five patients have been discovered in a prospective study on the etiology of febrile illnesses occurring within six weeks following a tick bite, conducted at the Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia. The diagnosis of acute HGE was established by seroconversion to the HGE agent and/or molecular identification of ehrlichial organisms. None of the patients had detectable morulae on blood smear examination. Clinical characteristics and laboratory findings were similar to those reported from the United States, although the disease course was relatively mild in the Slovenian cases. All patients recovered rapidly and without sequelae, although only three patients received antibiotic therapy (of whom only two were treated with doxycycline). Many ehrlichiosis cases could go undetected due to a lack of physician awareness, lack of public knowledge, or limited investigation. HGE should now be also included in the differential diagnosis of febrile illnesses occurring after a tick bite in Europe.
Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia.
S
S
Lotric-Furlan
M
M
Petrovec
T
T
Avsic-Zupanc
W L
WL
Nicholson
J W
JW
Sumner
J E
JE
Childs
F
F
Strle
D000208:Acute Disease; D000328:Adult; D000368:Aged; D018469:Ehrlichia chaffeensis; D016873:Ehrlichiosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017524:Slovenia / Q000453:epidemiology; D017282:Tick-Borne Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology