HUMAN GRANULOCYTIC EHRLICHIOSIS IN EUROPE - CLINICAL AND LABORATORY FINDINGS FOR 4 PATIENTS FROM SLOVENIA

Febrile illnesses following a tick bite in patients from Slovenia were evaluated for an ehrlichial etiology, A case of acute human granulocy tic ehrlichiosis (HGE) was confirmed by seroconversion to the HGE agen t or molecular identification of ehrlichial organisms. Acute infection with the HGE agent was confirmed in four patients. None of the patien ts had detectable antibodies to the HGE agent at their first visit, bu t polymerase chain reaction analysis was positive for three patients. All four patients subsequently seroconverted to the HGE agent as shown by high titers of antibody, Clinical features and laboratory findings were similar to those in reports from the United States, although the disease course was relatively mild in the Slovenian cases. All patien ts recovered rapidly and without sequelae, although only two received antibiotic therapy (of whom only one was treated with doxycycline). HG E is an emerging tick-borne disease in the United States and should no w be included in the differential diagnosis of febrile illnesses occur ring after a tick bite in Europe.