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Human Granulocytic Ehrlichiosis in Massachusetts

Sam R. Telford; Timothy J. Lepore; Patricia Snow; Cynthia K. Warner; and Jacqueline E. Dawson
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From Harvard School of Public Health, Boston, Massachusetts. Nantucket Cottage Hospital, Nantucket, Massachusetts. The Centers for Disease Control and Prevention, Atlanta, Georgia. Requests for Reprints: Sam R. Telford III, DSc, Department of Tropical Public Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115. Acknowledgments: The authors thank R.E. Corstvet for supplying antigen slides, and Vanesa Baker for technical assistance. Grant Support: By National Institutes of Health grant AI19693, Smith Kline Beecham Pharmaceuticals, the Chace Fund, and the Gibson Island Corporation.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;123(4):277-279. doi:10.7326/0003-4819-123-4-199508150-00006
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Two new tick-borne zoonoses have recently emerged as threats to public health in North America. Both are caused by infection with Ehrlichia species, obligate intracellular bacteria that localize within the phagosomes of leukocytes. The spectrum of illness varies from mild to severe; about one third of patients require hospitalization. Persons exposed to ticks may present with a “spotless spotted fever” or a disease similar to Lyme disease that does not feature erythema and is accompanied by fever, chills, severe headache, myalgia, malaise, and nausea. A maculopapular or petechial rash, however, may be present [12]. Laboratory findings include thrombocytopenia, leukopenia, and abnormal hepatic function test results. Treatment with tetracyclines induces defervescence within 48 hours.

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Grahic Jump Location
Figure 1.
Morula (arrow) within a metamyelocyte from the patient's blood (buffy-coat smear, Wolbach Giemsa stain; original magnification, × 1250).
Grahic Jump Location




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