Lotric-Furlan S, Petrovec M, Avsic-Zupanc T, Nicholson W L, Sumner J W, Childs J E, Strle F
Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia.
Wien Klin Wochenschr. 1998 Dec 23;110(24):894-7.
Ehrlichioses are tick-transmitted diseases associated with illnesses of animals for decades, but recently recognised to be emerging human diseases. In the last ten years increasing number of cases of human infections caused by Ehrlichia chaffeensis and granulo-cytic ehrlichia were described in the United States. Several reports also indicate the presence of infection with the human granulocytic ehrlichiosis (HGE) agent in Europe. The first confirmed acute human disease caused by HGE agent was reported from Slovenia. Until 1997, five patients have been discovered in a prospective study on the etiology of febrile illnesses occurring within six weeks following a tick bite, conducted at the Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia. The diagnosis of acute HGE was established by seroconversion to the HGE agent and/or molecular identification of ehrlichial organisms. None of the patients had detectable morulae on blood smear examination. Clinical characteristics and laboratory findings were similar to those reported from the United States, although the disease course was relatively mild in the Slovenian cases. All patients recovered rapidly and without sequelae, although only three patients received antibiotic therapy (of whom only two were treated with doxycycline). Many ehrlichiosis cases could go undetected due to a lack of physician awareness, lack of public knowledge, or limited investigation. HGE should now be also included in the differential diagnosis of febrile illnesses occurring after a tick bite in Europe.
埃立克体病是由蜱传播的疾病，数十年来一直与动物疾病相关，但最近被认为是新兴的人类疾病。在过去十年中，美国报告了越来越多由恰菲埃立克体和粒细胞埃立克体引起的人类感染病例。一些报告还表明欧洲存在人类粒细胞埃立克体病（HGE）病原体感染。斯洛文尼亚报告了首例由HGE病原体引起的确诊急性人类疾病。截至1997年，在斯洛文尼亚卢布尔雅那大学医学中心传染病科对蜱叮咬后六周内发生的发热性疾病病因进行的一项前瞻性研究中，发现了五例患者。急性HGE的诊断通过血清转化为HGE病原体和/或埃立克体生物体的分子鉴定来确定。所有患者血液涂片检查均未发现桑葚体。临床特征和实验室检查结果与美国报告的相似，尽管斯洛文尼亚病例的病程相对较轻。所有患者均迅速康复且无后遗症，尽管只有三名患者接受了抗生素治疗（其中只有两名用强力霉素治疗）。由于医生认识不足、公众知识缺乏或调查有限，许多埃立克体病病例可能未被发现。现在欧洲蜱叮咬后发生的发热性疾病的鉴别诊断中也应包括HGE。
