title: Human granulocytic ehrlichiosis in Northern California: two case descriptions with genetic analysis of the Ehrlichiae.
abstract: We report two cases of human granulocytic ehrlichiosis (HGE) that occurred in northern California in summer 1998. Patients had fever, malaise, and myalgia, reported tick bites, had moderate thrombocytopenia, and had normal or slightly elevated liver enzyme activities. Ehrlichial inclusions were observed in the blood of one patient, and HGE-agent DNA was amplified by PCR from both patients. Genetically, the strains resembled horse isolates from northern California. The close spatial and temporal proximity of the two new cases may be due to a nidus of infection in the area or heightened surveillance by local physicians.
authors.affiliation: School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, Davis 95616, USA. jefoley@ucdavis.edu
authors.forename: J E
authors.initials: JE
authors.lastname: Foley
authors.forename: L
authors.initials: L
authors.lastname: Crawford-Miksza
authors.forename: J S
authors.initials: JS
authors.lastname: Dumler
authors.forename: C
authors.initials: C
authors.lastname: Glaser
authors.forename: J S
authors.initials: JS
authors.lastname: Chae
authors.forename: E
authors.initials: E
authors.lastname: Yeh
authors.forename: D
authors.initials: D
authors.lastname: Schnurr
authors.forename: R
authors.initials: R
authors.lastname: Hood
authors.forename: W
authors.initials: W
authors.lastname: Hunter
authors.forename: J E
authors.initials: JE
authors.lastname: Madigan
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001483:Base Sequence; D002140:California; D002415:Cats; D004269:DNA, Bacterial; D004318:Doxycycline / Q000627:therapeutic use; D004536:Ehrlichia / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification; D016873:Ehrlichiosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D005260:Female; D006098:Granulocytes; D018922:HL-60 Cells; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010542:Peromyscus; D017422:Sequence Analysis, DNA
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004318:Doxycycline