Human Ehrlichiosis in the United States

摘要: In 1986, a 51-year-old man hospitalized with an illness clinically resembling “spotless” Rocky Mountain spotted fever was shown to have ehrlichiosis. Subsequently, 100 additional cases among patients in 15 states been identified by various investigators. Most had recent tick exposure, and acute febrile nonspecific symptoms mild degrees of liver dysfunction, leukopenia, thrombocytopenia. Intraleukocytic inclusions found only three cases. Active surveillance Georgia revealed rate 5.3 per 100,000 population. Cases differed from the noncases that they were more likely report bite (P < 0.02) reside rural county 0.02). also lower white blood cell counts 0.001), platelet = 0.01), higher aspartate aminotransferase 0.005) alanine 0.01) levels at time admission hospital. Ehrlichiosis is important cause some parts United States, distinguishable other illnesses, primarily history presence abnormal hematology function test results. The putative etiologic agent has not isolated, but considered be closely related E. canis. possibility zooanthropozoonotic nature erlichiosis discussed remains largely speculative epidemiologically unsubstantiated. differential diagnosis ehrlichiosis-like disease (without rash) criteria for ehrlichiosis case definition are suggested.