Arraga-Alvarado C, Montero-Ojeda M, Bernardoni A, Anderson B E, Parra O
Facultad de Ciencias Veterinarias, Universidad del Zulia, Venezuela.
Invest Clin. 1996 Mar;37(1):35-49.
Human ehrlichiosis is a zoonotic disease, caused by a rickettsia that infects leukocytes. It was described for the first time in the United States of America in 1986. More than 300 cases have been reported in that country. One case has been reported in Portugal, two in France and one more in a tourist coming from Mali (Africa). In Venezuela, a tropical country, where ehrlichiosis is endemic in dogs and horses, the first case of human ehrlichiosis is reported in a seventeen month old girl. She initially had symptoms compatible with a viral illness. Then she developed a rash, acute respiratory failure, hepato-splenomegaly, neurologic abnormalities, renal failure and hematologic alterations including pancytopenia and disseminated intravascular coagulation (DIC). Different diagnoses were given before it was concluded that it was a case of ehrlichiosis. She was treated with tetracycline and very soon recovered. The initial diagnosis was made using buffy coat blood smears stained with Diff Quick Stain. Indirect Immunofluorescence (IFA) test was used to detect antibodies against Ehrlichia chaffeensis (1:126) but not to other rickettsias. Also the presence of platelets with ehrlichia bodies similar to E. platys from dogs, it was demonstrated, in peripheral blood from the child. The presence of these bodies in human platelets has not been previously reported. In this case, it could not be proved that the disease was transmitted by a tick bite. The presence of ehrlichia bodies in platelets from the girl's peripheral blood is also described.
人埃立克体病是一种人畜共患病，由一种感染白细胞的立克次氏体引起。1986年在美国首次被描述。该国已报告300多例病例。葡萄牙报告了1例，法国报告了2例，还有1例发生在一名来自马里（非洲）的游客身上。在委内瑞拉这个热带国家，埃立克体病在犬类和马匹中呈地方性流行，该国报告了首例人类埃立克体病病例，患者为一名17个月大的女孩。她最初出现了与病毒性疾病相符的症状。随后她出现了皮疹、急性呼吸衰竭、肝脾肿大、神经异常、肾衰竭以及血液学改变，包括全血细胞减少和弥散性血管内凝血（DIC）。在确诊为埃立克体病之前给出了不同的诊断。她接受了四环素治疗，很快康复。最初的诊断是通过用Diff Quick染色法对血沉棕黄层血涂片进行染色做出的。间接免疫荧光（IFA）试验用于检测针对查菲埃立克体的抗体（1:126），但未检测其他立克次氏体。此外，在该儿童的外周血中证实存在与犬类的血小板埃立克体相似的含埃立克体的血小板。此前尚未报道人类血小板中存在这些物体。在这个病例中，无法证明该病是由蜱叮咬传播的。文中还描述了该女孩外周血血小板中存在埃立克体。
