title: Clinical outcomes of solid organ transplant recipients with ehrlichiosis.
abstract: Because of our experience with severe Ehrlichia infections in lung transplant recipients, we reviewed all cases of ehrlichiosis in solid organ transplant recipients at Barnes-Jewish Hospital in St. Louis, Missouri. Between 1996 and 2007, 25 cases of ehrlichiosis were identified. We retrospectively collected demographic, clinical, laboratory, and outcomes data, and we compared the 5 cases in lung transplant recipients with 20 cases in other solid organ transplant recipients (heart, 2; kidney, 13; liver, 5). The presenting symptoms in the majority of both groups consisted of fever and headache. Clinical outcomes were worse in the lung transplant group and included a greater need for intensive care unit treatment (80% vs. 20%, P=0.02), longer length of hospital stay (21 vs. 5 days, P=0.02), and propensity to develop acute lung injury or acute respiratory distress syndrome (60% vs. 10%, P=0.04). No mortalities occurred in either group of patients. In an endemic area, ehrlichiosis is not unusual in solid organ transplant recipients, and lung transplant recipients tend to have a more severe illness.
authors.affiliation: Department of Medicine, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri, USA. klawrenc@im.wustl.edu
authors.forename: K L
authors.initials: KL
authors.lastname: Lawrence
authors.forename: M R
authors.initials: MR
authors.lastname: Morrell
authors.forename: G A
authors.initials: GA
authors.lastname: Storch
authors.forename: R R
authors.initials: RR
authors.lastname: Hachem
authors.forename: E P
authors.initials: EP
authors.lastname: Trulock
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004536:Ehrlichia / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D016873:Ehrlichiosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents