A Naval Academy midshipman with ehrlichiosis after summer field exercises in Quantico, Virginia.
A case of human ehrlichiosis (caused by infection with Ehrlichia chaffeensis) is presented. The patient was a female Naval Academy midshipman with a 26-day history of daily field training with the U.S. Marines near Quantico, Virginia. She presented with a several-day history of myalgias, fever, and frontal headache. During her clinical course, she developed fever to 104 degrees F, dry cough, dyspnea on exertion, arthralgias, and nephrotic syndrome. She did not develop a rash. Laboratory studies were significant for thrombocytopenia, equivocal Lyme enzyme immunosorbent assay with a negative confirmatory western immunoblot, equivocal Rocky Mountain spotted fever acute serology without a convalescent increase in immunoglobulin G, and immunoglobulin G/immunoglobulin M serology positive for human monocytic ehrlichiosis. She manifested known sequelae for this emerging disease, including dyspnea, pedal edema, increased transminases, and nephrotic syndrome.
Naval Ambulatory Care Center, Internal Medicine, Newport, RI 02841, USA.
T B
TB
Rooney
T E
TE
McGue
K C
KC
Delahanty
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015153:Blotting, Western; D003371:Cough / Q000382:microbiology; D004318:Doxycycline / Q000627:therapeutic use; D004417:Dyspnea / Q000382:microbiology; D016873:Ehrlichiosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D005260:Female; D005334:Fever / Q000382:microbiology; D006261:Headache / Q000382:microbiology; D006801:Humans; D007124:Immunoenzyme Techniques; D007318:Inservice Training; D008889:Military Personnel; D009326:Naval Medicine; D010146:Pain / Q000382:microbiology; D013921:Thrombocytopenia / Q000382:microbiology; D014768:Virginia
D000900:Anti-Bacterial Agents; D004318:Doxycycline