Human Monocytotropic Ehrlichiosis, Missouri
Published Date:Dec 2003
Source:Emerg Infect Dis. 9(12):1579-1586.
Fluorescent Antibody Technique, Indirect
Human Anaplasmosis (formerly Known As Human Granulocytotropic Ehrlichiosis Or HGE)
Human Monocytotropic Ehrlichiosis (HME)
Polymerase Chain Reaction
Polymerase Chain Reaction (PCR)
RNA, Ribosomal, 16S
Sequence Analysis, DNA
Funding:HR8/CCH613372/HR/NHLBI NIH HHS/United States
Description:To determine the incidence, clinical and laboratory characteristics, and utility of molecular diagnosis of human monocytotropic ehrlichiosis (HME) in the primary care setting, we conducted a prospective study in an outpatient primary care clinic in Cape Girardeau, Missouri. One hundred and two patients with a history of fever for 3 days (>37.7 degrees C), tick bite or exposure, and no other infectious disease diagnosis were enrolled between March 1997 and December 1999. HME was diagnosed in 29 patients by indirect immunofluorescent antibody assay and polymerase chain reaction (PCR). Clinical and laboratory manifestations included fever (100%), headache (72%), myalgia or arthralgia (69%), chills (45%), weakness (38%), nausea (38%), leukopenia (60%), thrombocytopenia (56%), and elevated aspartate aminotransferase level (52%). Hospitalization occurred in 41% of case-patients. PCR sensitivity was 56%; specificity, 100%. HME is a prevalent, potentially severe disease in southeastern Missouri that often requires hospitalization. Because clinical presentation of HME is nonspecific, PCR is useful in the diagnosis of acute HME.
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