Human monocytic ehrlichiosis: An emerging pathogen in transplantation

Henkie P. Tan, J. Stephen Dumler, Warren R. Maley, Andrew S. Klein, James F. Burdick, F. Fred Poordad, Paul J. Thuluvath, Jay S. Markowitz

Producción científica: Articlerevisión exhaustiva

32 Citas (Scopus)

Resumen

Background. The spectrum of disease caused by Ehrlichia spp. ranges from asymptomatic to fatal. Awareness and early diagnosis of the infection is paramount because appropriate therapy leads to rapid defervescence and cure. If left untreated, particularly in immunosuppressed patients, ehrlichioses may result in multi-system organ failure and death. Methods. We report the second case of human monocytic ehrlichiosis (HME) in a liver transplant recipient, and review the literature. Results. The patient presented with fever and headache, had negative cultures, and despite broad-spectrum antimicrobial coverage appeared progressively septic. After eliciting a history of tick exposure we treated the patient empirically with doxycycline. The diagnosis of HME was confirmed by 1) polymerase chain reaction (PCR) for Ehrlichia chaffeensis, 2) acute and convalescent serum titers, and 3) in vitro cultivation of E chaffeensis from peripheral blood. Conclusion. Although human ehrlichioses are relatively uncommon, they are emerging as clinically significant arthropod-borne infections. Although epidemiological exposure is responsible for infection, immunosuppression makes patients more likely to succumb to disease. A high index of suspicion and early treatment results in a favorable outcome.

Idioma originalEnglish (US)
Páginas (desde-hasta)1678-1680
Número de páginas3
PublicaciónTransplantation
Volumen71
N.º11
DOI
EstadoPublished - jun 15 2001
Publicado de forma externa

ASJC Scopus subject areas

  • Transplantation

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