Recurrent Human Granulocytic Ehrlichiosis and Lyme Disease
Authors: Harold W. Horowitz
Journal: Annals of Internal Medicine (1999)

Letters15 June 1999Recurrent Human Granulocytic Ehrlichiosis and Lyme DiseaseHarold W. Horowitz, MD, Maria E. Aguero-Rosenfeld, MD, and Gary P. Wormser, MDHarold W. Horowitz, MDWestchester Medical Center; Valhalla, NY 10595 (Horowitz)Westchester Medical Center; Valhalla, NY 10595 (Aguero-Rosenfeld)Westchester Medical Center; Valhalla, NY 10595 (Wormser)Search for more papers by this author, Maria E. Aguero-Rosenfeld, MDWestchester Medical Center; Valhalla, NY 10595 (Horowitz)Westchester Medical Center; Valhalla, NY 10595 (Aguero-Rosenfeld)Westchester Medical Center; Valhalla, NY 10595 (Wormser)Search for more papers by this author, and Gary P. Wormser, MDWestchester Medical Center; Valhalla, NY 10595 (Horowitz)Westchester Medical Center; Valhalla, NY 10595 (Aguero-Rosenfeld)Westchester Medical Center; Valhalla, NY 10595 (Wormser)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-12-199906150-00101 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Johnson comments that our patient with recurrent human granulocytic ehrlichiosis and recurrent Lyme disease did not develop antibodies to B. burgdorferi after her initial infection in 1994. Lack of seroreactivity to Lyme borrelial antigens has been reported to occur in about 10% of treated patients with culture-proven erythema migrans when serial antibody testing is done (1), for reasons not yet established. Dr. Johnson also makes the point that after the second episode of erythema migrans in July 1997, the Western blot became negative by 3 months whereas the ELISA result remained positive. He notes that the ELISA ...References1. Aguero-Rosenfeld ME, Nowakowski J, Bittker S, Cooper D, Nadelman RB, Wormser GP. Evolution of the serologic response to Borrelia burgdorferi in treated patients with culture-confirmed erythema migrans. J Clin Microbiol. 1996;34:1-9. CrossrefMedlineGoogle Scholar2. Guidelines for laboratory evaluation in the diagnosis of Lyme disease. American College of Physicians. Ann Intern Med. 1997; 127:1106-8. Google Scholar3. Wormser GP. A vaccine against Lyme disease. Ann Intern Med. 1995;123:627-9. LinkGoogle Scholar4. Steere AC, Sikand VK, Meurice F, Parenti DL, Fikrig E, Schoen RT, et al . Vaccination against Lyme disease with recombinant Borrelia burgdorferi outer-surface lipoprotein A with adjuvant. Lyme Disease Vaccine Study Group. N Engl J Med. 1998;339:209-15. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Harold W. Horowitz, MD; Maria E. Aguero-Rosenfeld, MD; Gary P. Wormser, MDAffiliations: Westchester Medical Center; Valhalla, NY 10595 (Horowitz)Westchester Medical Center; Valhalla, NY 10595 (Aguero-Rosenfeld)Westchester Medical Center; Valhalla, NY 10595 (Wormser) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReinfection with the Agent of Human Granulocytic Ehrlichiosis Harold W. Horowitz , Maria Aguero-Rosenfeld , J. Stephen Dumler , Donna F. McKenna , Tze-chen Hsieh , Joseph Wu , Ira Schwartz , and Gary P. Wormser Recurrent Human Granulocytic Ehrlichiosis and Lyme Disease James R. Johnson Metrics 15 June 1999Volume 130, Issue 12Page: 1029-1030KeywordsAntibodiesEhrlichiosisEnzyme linked immunosorbent assayErythemaInfectious diseasesLipoproteinsLyme diseaseResearch laboratoriesSpecificityWestern blot ePublished: 15 August 2000 Issue Published: 15 June 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...