DUAL INFECTION WITH EHRLICHIA-CHAFFEENSIS AND A SPOTTED-FEVER GROUP RICKETTSIA - A CASE-REPORT

Well-documented cases of simultaneous human infection with more than o ne tickborne pathogen are rare. To our knowledge only two dual infecti ons have been reported: simultaneous human infection with the agent of human granulocytic ehrlichiosis and Borrelia burgdorferi and simultan eous human infection with B. burgdorferi and Babesia microti (1-2). Ro cky Mountain spotted fever has long been known to be endemic in North Carolina; cases of human ehrlichial infection were recognized there so on after Ehrlichia chaffeensis was recognized as an important cause of tick-borne disease in the southeastern United States. Because both Ro cky Mountain spotted fever and ehrlichiosis are prevalent in North Car olina, occasional cases of simultaneous human infection by rickettsial and ehrlichial agents would not be surprising; however, no such cases seem to have been reported.