Hardalo C J, Quagliarello V, Dumler J S
Department of Internal Medicine, Morristown Memorial Hospital, New Jersey, USA.
Clin Infect Dis. 1995 Oct;21(4):910-4. doi: 10.1093/clinids/21.4.910.
We report a case of granulocytic ehrlichiosis in a 71-year-old man who presented with an acute febrile illness and subsequently developed multisystem organ dysfunction and sudden severe anemia with thrombocytopenia requiring intensive care, mechanical ventilation, hemodialysis, and transfusions. The diagnosis was suspected on the fifth hospital day after a peripheral blood smear was examined; intracytoplasmic inclusion bodies were present in granulocytes only. Results of serological tests of acute and convalescent sera confirmed the diagnosis of granulocytic ehrlichiosis. We discuss the features of this case that were similar to those of published case reports as well as the course and outcome of treatment. This, to our knowledge, represents to first documented case of human granulocytic ehrlichiosis to occur outside the Upper Midwest. Because of the possible epidemiological association of Ehrlichia species with the deer tick Ixodes scapularis (dammini), this case raises additional concern for clinicians and patients in regions where Lyme disease is endemic.
我们报告一例71岁男性粒细胞埃立克体病病例。该患者起初表现为急性发热性疾病，随后发展为多系统器官功能障碍，并突然出现严重贫血伴血小板减少，需要重症监护、机械通气、血液透析及输血治疗。在外周血涂片检查后的住院第5天怀疑该病诊断；仅在粒细胞中发现胞浆内包涵体。急性期和恢复期血清的血清学检测结果确诊为粒细胞埃立克体病。我们讨论了该病例与已发表病例报告相似的特征以及治疗过程和结果。据我们所知，这是上中西部地区以外首次记录的人类粒细胞埃立克体病病例。由于埃立克体属物种可能与肩突硬蜱（达氏硬蜱）存在流行病学关联，该病例引起了莱姆病流行地区临床医生和患者的更多关注。
