Document Detail


Ehrlichiosis presenting as a life-threatening illness with features of the toxic shock syndrome.
MedLine Citation:
PMID:  8213865     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe clinical and laboratory features of patients with severe ehrlichiosis, some of whom presented with toxic shock syndrome (TSS)-like illnesses, and to report, to our knowledge, the first documented fatal case of ehrlichiosis in a child. DESIGN: Case series. SETTING: Tertiary-care medical center. PATIENTS: All patients with documented ehrlichiosis during a 3-year period, August 1, 1989, to July 31, 1992. RESULTS: Eight patients (age range: 2 to 46 years) met clinical and serologic diagnostic criteria for ehrlichiosis. The mean interval from first contact with a physician to initiation of appropriate antibiotic therapy was 4.6 days (range: 1 to 11 days). All eight patients with ehrlichiosis had fever, chills, thrombocytopenia, and abnormal liver function test results. Most patients also had rash (seven), conjunctival hemorrhage or erythema (six), and leukopenia (six). Four cases met diagnostic criteria for TSS with fever, hypotension, rash, and multiorgan dysfunction. Two patients required mechanical ventilation, and one of these, a 6 1/2-year-old boy, died of complications of the infection. A ninth patient with probable ehrlichiosis also met diagnostic criteria for TSS. CONCLUSIONS: Human ehrlichiosis can present as a severe, life-threatening illness that may resemble TSS. The diagnosis of ehrlichiosis was not considered by the physicians who first cared for these patients. Greater awareness of the potential severity of ehrlichiosis is needed to ensure that proper treatment is initiated early in the course of the disease.
Authors:
C J Fichtenbaum; L R Peterson; G J Weil
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  95     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-11-10     Completed Date:  1993-11-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  351-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Diagnosis, Differential
Ehrlichiosis / complications,  diagnosis*,  therapy
Female
Humans
Male
Middle Aged
Shock, Septic / etiology*
Treatment Outcome
Comments/Corrections
Comment In:
Am J Med. 1995 Mar;98(3):318-9   [PMID:  7872355 ]
Am J Med. 1995 Jul;99(1):107   [PMID:  7598131 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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