Document Detail

Human monocytic ehrlichiosis.
MedLine Citation:
PMID:  15536115     Owner:  NLM     Status:  MEDLINE    
A 56-year-old man with a history of Wegener granulomatosis presented with 6 days of sinus congestion, fever, malaise, myalgias, episcleritis, and a morbilliform rash. An exacerbation of Wegener granulomatosis was the principal concern because of the frequency of flares in that disease. The patient developed acute renal failure, thrombocytopenia, transaminitis, and, finally, severe myocarditis that led to congestive heart failure. Additional history-taking and the evolution of his clinical features led to empirical treatment with doxycycline for human monocytic ehrlichiosis (HME). The diagnosis of HME was confirmed by both a polymerase chain reaction assay for Ehrlichia chaffeensis and by the demonstration of morulae within peripheral blood mononuclear cells. The patient improved promptly following institution of doxycycline, and his cardiac function returned to normal over a period of 4 months.
John H Stone; Kerry Dierberg; Ghazaleh Aram; J Stephen Dumler
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Publication Detail:
Type:  Case Reports; Clinical Conference; Journal Article    
Journal Detail:
Title:  JAMA     Volume:  292     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-10     Completed Date:  2004-11-15     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2263-70     Citation Subset:  AIM; IM    
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Diagnosis, Differential
Doxycycline / therapeutic use
Ehrlichia chaffeensis / isolation & purification*
Ehrlichiosis* / complications,  diagnosis,  drug therapy,  epidemiology
Heart Failure / etiology
Middle Aged
Monocytes / microbiology
Polymerase Chain Reaction
Wegener Granulomatosis / complications
Reg. No./Substance:
0/Anti-Bacterial Agents; N12000U13O/Doxycycline

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

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