The incidence of ehrlichial and rickettsial infection in patients with unexplained fever and recent history of tick bite in central North Carolina.
We examined the clinical and laboratory findings of a consecutive series of patients from central North Carolina presenting with fever and a history of tick bite within the preceding 14 days. Evidence of a tick-transmitted pathogen was detected in 16 of 35 patients enrolled over a 2-year period. Nine patients were infected with Ehrlichia chaffeensis, and 6 were infected with a spotted fever group rickettsia; 1 patient had evidence of coinfection with E. chaffeensis and a spotted fever group rickettsia. Four patients had detectable antibodies against the human granulocytic ehrlichiosis agent; however, only 2 had a 4-fold antibody titer rise without detectable antibodies against E. chaffeensis. The other 2 were thought to have cross-reacting antibodies to E. chaffeensis. We conclude that ehrlichial infections may be as common as spotted fever group rickettsial infections in febrile patients from central North Carolina with a recent history of tick bite.
Carpenter
C F
CF
Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Gandhi
T K
TK
Kong
L K
LK
Corey
G R
GR
Chen
S M
SM
Walker
D H
DH
Dumler
J S
JS
Breitschwerdt
E
E
Hegarty
B
B
Sexton
D J
DJ
D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D015897:Comorbidity; D018469:Ehrlichia chaffeensis / Q000302:isolation & purification; D016873:Ehrlichiosis / Q000097:blood / Q000453:epidemiology*; D005335:Fever of Unknown Origin / Q000097:blood / Q000209:etiology / Q000382:microbiology*; D006801:Humans; D015994:Incidence; D007299:Insect Bites and Stings; D007958:Leukocyte Count; D009657:North Carolina / Q000453:epidemiology; D010976:Platelet Count; D016133:Polymerase Chain Reaction; D012281:Rickettsia / Q000302:isolation & purification; D012282:Rickettsia Infections / Q000097:blood / Q000453:epidemiology*; D013987:Ticks
D000907:Antibodies, Bacterial