Near fatal acute respiratory distress syndrome in a patient with human ehrlichiosis

Human ehrlichiosis is not a common cause of acute respiratory distress synd rome (ARDS), Physicians should be aware of this life-threatening but treata ble entity. Progression to ARDS may be related to delay in diagnosis and tr eatment. Fever, leukopenia, thrombocytopenia, and a history of tick exposur e in an endemic area during the spring and summer months should alert the p hysician to the possibility of human ehrlichiosis, since a definitive diagn osis requires serologic testing that may take weeks to confirm. We describe a case of ARDS resulting from human ehrlichiosis. A unique feature in our case was that despite the early use of doxycycline, the patient had near fa tal ARDS that responded dramatically to high doses of steroids.