HUMAN GRANULOCYTIC EHRLICHIOSIS - A CASE SERIES FROM A MEDICAL-CENTERIN NEW-YORK-STATE

Background: Human granulocytic ehrlichiosis (HGE) is a newly described illness with few reports in the literature. Objective: To describe th e clinical and laboratory features of Design: Case series. Setting: Te rtiary care facility in New York State. Patients: is adult patients wi th HGE. Measurements: Epidemiologic, clinical, and laboratory features ; treatment; and outcome of patients with HGE. Results: Patients prese nted 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 patien ts, and abnormal liver enzyme levels were seen in 81%. Results of poly merase 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 wa s cultured from 2 patients. All but one patient (94%) developed antibo dies to Ehrlichia equi. Five patients (28%) were briefly hospitalized, and none died. All patients were successfully treated with doxycyclin e. Conclusions: The illness associated with HGE in these patients from the northeastern United States was more mild than that originally des cribed in reports of HGE in the midwestern United States.