PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jcmPermissionsJournals.ASM.orgJournalJCM ArticleJournal InfoAuthorsReviewers
 
J Clin Microbiol. 1997 June; 35(6): 1556–1559.
PMCID: PMC229786

Human disease in Europe caused by a granulocytic Ehrlichia species.

Abstract

Human granulocytic ehrlichiosis (HGE) was recently described in North America. It is caused by an Ehrlichia species closely related to Ehrlichia phagocytophila and Ehrlichia equi, recognized to infect mostly ruminants and horses, respectively. The vector in North America is the tick Ixodes scapularis, which is also the vector of the Lyme disease agent, Borrelia burgdorferi. Previous serologic studies in patients with a diagnosis of Lyme borreliosis indicate that HGE may exist in Europe. We report the first documented case of HGE in Europe. The diagnosis was established by seroconversion to E. equi and the HGE agent and by PCR with sequence analysis of the gene encoding the HGE agent 16S rRNA. Interestingly, the patient presented with a self-limited but moderately severe illness. Thus, European physicians need to be aware that HGE exists in Europe and that the diagnosis should be considered in febrile patients with tick bites in areas where Lyme disease is endemic.

Full Text

The Full Text of this article is available as a PDF (273K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Aguero-Rosenfeld ME, Horowitz HW, Wormser GP, McKenna DF, Nowakowski J, Muñoz J, Dumler JS. Human granulocytic ehrlichiosis: a case series from a medical center in New York State. Ann Intern Med. 1996 Dec 1;125(11):904–908. [PubMed]
  • Anderson BE, Dawson JE, Jones DC, Wilson KH. Ehrlichia chaffeensis, a new species associated with human ehrlichiosis. J Clin Microbiol. 1991 Dec;29(12):2838–2842. [PMC free article] [PubMed]
  • Bakken JS, Dumler JS, Chen SM, Eckman MR, Van Etta LL, Walker DH. Human granulocytic ehrlichiosis in the upper Midwest United States. A new species emerging? JAMA. 1994 Jul 20;272(3):212–218. [PubMed]
  • Bakken JS, Krueth J, Tilden RL, Dumler JS, Kristiansen BE. Serological evidence of human granulocytic ehrlichiosis in Norway. Eur J Clin Microbiol Infect Dis. 1996 Oct;15(10):829–832. [PubMed]
  • Bakken JS, Krueth J, Wilson-Nordskog C, Tilden RL, Asanovich K, Dumler JS. Clinical and laboratory characteristics of human granulocytic ehrlichiosis. JAMA. 1996 Jan 17;275(3):199–205. [PubMed]
  • Brouqui P, Dumler JS, Lienhard R, Brossard M, Raoult D. Human granulocytic ehrlichiosis in Europe. Lancet. 1995 Sep 16;346(8977):782–783. [PubMed]
  • Chen SM, Dumler JS, Bakken JS, Walker DH. Identification of a granulocytotropic Ehrlichia species as the etiologic agent of human disease. J Clin Microbiol. 1994 Mar;32(3):589–595. [PMC free article] [PubMed]
  • Edelman DC, Dumler JS. Evaluation of an Improved PCR Diagnostic Assay for Human Granulocytic Ehrlichiosis. Mol Diagn. 1996 Jun;1(1):41–49. [PubMed]
  • Johansson KE, Pettersson B, Uhlén M, Gunnarsson A, Malmqvist M, Olsson E. Identification of the causative agent of granulocytic ehrlichiosis in Swedish dogs and horses by direct solid phase sequencing of PCR products from the 16S rRNA gene. Res Vet Sci. 1995 Mar;58(2):109–112. [PubMed]
  • Lotric-Furlan S, Strle F. Thrombocytopenia--a common finding in the initial phase of tick-borne encephalitis. Infection. 1995 Jul-Aug;23(4):203–206. [PubMed]
  • Maeda K, Markowitz N, Hawley RC, Ristic M, Cox D, McDade JE. Human infection with Ehrlichia canis, a leukocytic rickettsia. N Engl J Med. 1987 Apr 2;316(14):853–856. [PubMed]
  • Morais JD, Dawson JE, Greene C, Filipe AR, Galhardas LC, Bacellar F. First European case of ehrlichiosis. Lancet. 1991 Sep 7;338(8767):633–634. [PubMed]
  • Picken MM, Picken RN, Han D, Cheng Y, Strle F. Single-tube nested polymerase chain reaction assay based on Flagellin gene sequences for detection of Borrelia burgdorferi sensu lato. Eur J Clin Microbiol Infect Dis. 1996 Jun;15(6):489–498. [PubMed]
  • Pierard D, Levtchenko E, Dawson JE, Lauwers S. Ehrlichiosis in Belgium. Lancet. 1995 Nov 4;346(8984):1233–1234. [PubMed]
  • Strle F, Nelson JA, Ruzic-Sabljic E, Cimperman J, Maraspin V, Lotric-Furlan S, Cheng Y, Picken MM, Trenholme GM, Picken RN. European Lyme borreliosis: 231 culture-confirmed cases involving patients with erythema migrans. Clin Infect Dis. 1996 Jul;23(1):61–65. [PubMed]
  • Sumption KJ, Wright DJ, Cutler SJ, Dale BA. Human ehrlichiosis in the UK. Lancet. 1995 Dec 2;346(8988):1487–1488. [PubMed]
  • Wormser GP, Horowitz HW, Dumler JS, Schwartz I, Aguero-Rosenfeld M. False-positive Lyme disease serology in human granulocytic ehrlichiosis. Lancet. 1996 Apr 6;347(9006):981–982. [PubMed]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)