Bakken J S, Aguero-Rosenfeld M E, Tilden R L, Wormser G P, Horowitz H W, Raffalli J T, Baluch M, Riddell D, Walls J J, Dumler J S
Section of Infectious Diseases, St. Mary's Hospital-Duluth Health System, Duluth, MN 55805, USA.
Clin Infect Dis. 2001 Mar 15;32(6):862-70. doi: 10.1086/319350. Epub 2001 Mar 7.
To describe the changes that occur in blood count parameters during the natural course of human granulocytic ehrlichiosis, we designed a retrospective cross-sectional case study of 144 patients with human granulocytic ehrlichiosis and matched controls who had a different acute febrile illness. Patients from New York State and the upper Midwest were evaluated from June 1990 through December 1998. Routine complete blood counts and manual differential leukocyte counts of peripheral blood were performed on blood samples that were collected during the active illness, and values were recorded until the day of treatment with an active antibiotic drug. Thrombocytopenia was observed more frequently than was leukopenia, and the risk of having ehrlichiosis varied inversely with the granulocyte count and the platelet count. Patients with ehrlichiosis displayed relative and absolute lymphopenia and had a significant increase in band neutrophil counts during the first week of illness. Knowledge of characteristic complete blood count patterns that occur during active ehrlichiosis may help clinicians to identify patients who should be evaluated specifically for ehrlichiosis and who should receive empiric antibiotic treatment with doxycycline.
为描述人类粒细胞埃立克体病自然病程中血细胞计数参数的变化，我们设计了一项回顾性横断面病例对照研究，研究对象为144例人类粒细胞埃立克体病患者以及患有其他急性发热性疾病的匹配对照。对1990年6月至1998年12月期间来自纽约州和中西部上游地区的患者进行了评估。对在疾病活动期采集的血样进行外周血常规全血细胞计数和手工白细胞分类计数，并记录数值直至开始使用活性抗生素治疗之日。血小板减少症的发生率高于白细胞减少症，患埃立克体病的风险与粒细胞计数和血小板计数呈负相关。埃立克体病患者表现出相对性和绝对性淋巴细胞减少，且在发病第一周杆状核中性粒细胞计数显著增加。了解活动期埃立克体病期间出现的特征性全血细胞计数模式，可能有助于临床医生识别那些应接受埃立克体病特异性评估以及那些应接受强力霉素经验性抗生素治疗的患者。
