Human granulocytic ehrlichiosis: a case series from a medical center in New York State.

BACKGROUND

Human granulocytic ehrlichiosis (HGE) is a newly described illness with few reports in the literature.

OBJECTIVE

To describe the clinical and laboratory feature of HGE.

DESIGN

Case series.

SETTING

Tertiary care facility in New York State.

PATIENTS

18 adult patients with HGE.

MEASUREMENTS

Epidemiologic, clinical, and laboratory features; treatment; and outcome of patients with HGE.

RESULTS

Patients presented with such symptoms as fever (94%) and myalgia or arthralgia (78%). Thirteen patients (71%) recalled being bitten by a tick before onset of symptoms. Leukopenia or thrombocytopenia was seen in 82% of patients, and abnormal liver enzyme levels were seen in 81%. Results of polymerase chain reaction were positive in 9 of 12 patients (75%); morulae were seen in 3 of 12 patients (25%); and the agent that causes HGE was cultured from 2 patients. All but one patient (94%) developed antibodies to Ehrlichia equi. Five patients (28%) were briefly hospitalized, and none died. All patients were successfully treated with doxycycline.

CONCLUSIONS

The illness associated with HGE in these patients from the northeastern United States was more mild than that originally described in reports of HGE in the midwestern United States.