Journal Article

Human Granulocytic Ehrlichiosis Presenting as Facial Diplegia in a 42-Year-Old Woman

Frederick S. Lee, Frederick K. Chu, Michelle Tackley, Allan D. Wu, Alireza Atri and Michael R. Wessels

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 5, pages 1288-1291
Published in print November 2000 | ISSN: 1058-4838
Published online November 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/317466
Human Granulocytic Ehrlichiosis Presenting as Facial Diplegia in a 42-Year-Old Woman

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Neurologic manifestations of human ehrlichiosis are unusual and have been described almost exclusively in human monocytic ehrlichiosis associated with Ehrlichia chaffeensis. We report here a case of a previously healthy 42-year-old woman who developed bilateral facial nerve palsies in association with infection by the agent of human granulocytic ehrlichiosis (aoHGE). The diagnosis was made by specific polymerase chain reaction amplification of aoHGE sequences from samples of the patient's blood and cerebrospinal fluid (CSF), as well as propagation of aoHGE in culture of HL60 cells inoculated with the patient's CSF. To our knowledge, this is the first report directly demonstrating the presence of aoHGE in CSF, and it underscores the importance of considering HGE in patients presenting with a nonspecific febrile illness and unexplained neurologic manifestations. HGE should also be considered in the differential diagnosis of bilateral facial palsy—a rare occurrence.

Journal Article.  2515 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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