Reinfection with the Agent of Human Granulocytic Ehrlichiosis
Authors: Harold W. Horowitz
Journal: Annals of Internal Medicine (1998)

Brief Communications15 September 1998Reinfection with the Agent of Human Granulocytic EhrlichiosisHarold W. Horowitz, MD, Maria Aguero-Rosenfeld, MD, J. Stephen Dumler, MD, Donna F. McKenna, ANP, Tze-chen Hsieh, PhD, Joseph Wu, PhD, Ira Schwartz, PhD, and Gary P. Wormser, MDHarold W. Horowitz, MDFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this author, Maria Aguero-Rosenfeld, MDFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this author, J. Stephen Dumler, MDFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this author, Donna F. McKenna, ANPFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this author, Tze-chen Hsieh, PhDFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this author, Joseph Wu, PhDFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this author, Ira Schwartz, PhDFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this author, and Gary P. Wormser, MDFrom New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-6-199809150-00007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Human granulocytic ehrlichiosis is an acute febrile illness caused by a still-unnamed organism, the human granulocytic ehrlichiosis agent, that is closely related to the veterinary pathogens Ehrlichia equi and E. phagocytophila[1-3]. Human granulocytic ehrlichiosis has been reported in an increasingly broad geographic area of the United States [1, 2] and in Europe [4]. Like Borrelia burgdorferi and Babesia microti, the etiologic agents of Lyme disease and babesiosis, respectively [5], the agent of human granulocytic ehrlichiosis is transmitted by Ixodes scapularis ticks [5]. We report what we believe to be the first documented case of reinfection with the human granulocytic ehrlichiosis ...References1. Bakken JS, Krueth J, Wilson-Nordskog C, Tilden RL, Asanovich K, Dumler JS. Clinical and laboratory characteristics of human granulocytic ehrlichiosis. JAMA. 1996; 275:199-205. Google Scholar2. Aguero-Rosenfeld ME, Horowitz HW, Wormser GP, McKenna DF, Nowakowski J, Munoz J, et al. Human granulocytic ehrlichiosis: a case series from a medical center in New York State. Ann Intern Med. 1996; 125:904-8. Google Scholar3. Chen SM, Dumler JS, Bakken JS, Walker DH. Identification of a granulocytic Ehrlichia species as the etiologic agent of human disease. J Clin Microbiol. 1994; 32:589-95. Google Scholar4. Petrovec M, Lotric Furlan S, Zupanc TA, Strle F, Brouqui P, Roux V, et al. Human disease in Europe caused by a granulocytic Ehrlichia species. J Clin Microbiol. 1997; 35:1556-9. Google Scholar5. 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Diagnosis of early Lyme disease by polymerase chain reaction amplification or culture of skin biopsies from erythema migrans lesions. J Clin Microbiol. 1992; 30:3082-8. Google Scholar10. Zhi N, Rikihisa Y, Kim HY, Wormser GP, Horowitz HW. Comparison of major antigenic proteins of six strains of the human granulocytic ehrlichiosis agent by Western immunoblot analysis. J Clin Microbiol. 1997; 35:2606-11. Google Scholar11. Nyindo MB, Ristic M, Lewis GE Jr, Huxsoll DL, Stephenson EH. Immune response of ponies to experimental infection with Ehrlichi equi. Am J Vet Res. 1978; 39:15-8. Google Scholar12. Chiao JW, Pavia C, Riley M, Altmann-Lasekan W, Abolhassani M, Liegner K, et al. Antigens of Lyme disease of spirochaete Borrelia burgdorferi inhibits antigen or mitogen-induced lymphocyte proliferation. FEMS Immunol Med Microbiol. 1994; 8:151-6. Google Scholar13. Stamp JT, Watt JA. Tick-borne fever as a cause of abortion in sheep. Veterinary Record. 1950; 62:465-8. Google Scholar14. Tuomi J. Experimental studies on bovine tick-borne fever. 1. Clinical and haematological data, some properties of the causative agent, and homologous immunity. Acta Pathol Microbiol Scand. 1967; 70:429-45. Google Scholar15. Nadelman RB, Horowitz HW, Hsieh TC, Wu JM, Aguero-Rosenfeld ME, Schwartz I, et al. Simultaneous human granulocytic ehrlichiosis and Lyme borreliosis. N Engl J Med. 1997; 337:27-30. Google Scholar16. Nowakowski J, Schwartz I, Nadelmann RB, Liveris D, Aguero-Rosenfeld M, Wormser GP. Culture-confirmed infection and reinfection with Borrelia burgdorferi. Ann Intern Med. 1997; 127:130-2. Google Scholar Author, Article, and Disclosure InformationAffiliations: From New York Medical College, Valhalla, New York; and Johns Hopkins Medical Institutions, Baltimore, Maryland.Acknowledgments: The authors thank Jobby Jacob, Mehdi Baluch, Fatemeh Kalantarpour, Shoba Varda, Susan Bittker, and Denise Cooper for technical assistance and Diane Holmgren for coordination of research activities.Grant Support: In part by the Westchester County Department of Health (grant CMC-2502 to Dr. Horowitz and grants HLT27017, HLT27018, and HLT27019 to Dr. Aguero-Rosenfeld); the Centers for Disease Control and Prevention (Cooperative Agreement U50/CCU 210280 to Dr. Wormser); the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant R01-AR41511 to Dr. Schwartz); Group 99, Inc., and the Philip Morris Co. (to Dr. Wu); and the National Institute of Allergy and Infectious Diseases (grant R01-AI41213-01 to Dr. Dumler).Corresponding Author: Harold Horowitz, MD, Division of Infectious Diseases, Westchester Medical Center, Room 209, Macy Pavilion, Valhalla, NY 10595.Current Author Addresses: Drs. Horowitz, Aguero-Rosenfeld, Hsieh, Wu, Schwartz, and Wormser and Ms. McKenna: Westchester Medical Center, Macy Pavilion, Valhalla, NY 10595. Dr. Dumler: Department of Pathology, Division of Medical Microbiology, Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD 21201. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRecurrent Human Granulocytic Ehrlichiosis and Lyme Disease James R. Johnson Recurrent Human Granulocytic Ehrlichiosis and Lyme Disease Harold W. Horowitz , Maria E. Aguero-Rosenfeld , and Gary P. 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Johnson, MDChanges in Expression of the 44-Kilodalton Outer Surface Membrane Antigen (p44 kD) for Monitoring Progression of Infection and Antimicrobial Susceptibility of the Human Granulocytic Ehrlichiosis (HGE) Agent in HL-60 Cells 15 September 1998Volume 129, Issue 6Page: 461-463KeywordsAntibodiesBorrelia burgdorferiDoxycyclineEhrlichiosisErythemaImmune responseImmunityLyme diseaseTemperatureTicks Issue Published: 15 September 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...