EHRLICHIOSIS - A CAUSE OF PROLONGED FEVER

Human ehrlichiosis is a recently described illness that is thought to be tick-borne. Most recognized cases of human ehrlichiosis manifest as an acute nonspecific febrile illness, The natural history of untreate d symptomatic disease is largely unknown. Over a 4-year period, we ide ntified 41 cases of human ehrlichiosis by serological testing, polymer ase chain reaction analysis, or both methods. The principal finding fo r six of the patients was protracted fever. The duration of their feve rs ranged from 17 to 51 days. At the time of presentation, all six pat ients had clinical features, laboratory features, or both consistent w ith a diagnosis of ehrlichiosis. Polymerase chain reaction analysis he lped to rapidly confirm the diagnosis for four of five patients tested . The diagnosis of human ehrlichiosis should be considered for patient s with prolonged fever who live in an area of endemicity.