Journal Article

Serial Measurements of Hematologic Counts during the Active Phase of Human Granulocytic Ehrlichiosis

Johan S. Bakken, Maria E. Aguero-Rosenfeld, Robert L. Tilden, Gary P. Wormser, Harold W. Horowitz, John T. Raffalli, Mehdi Baluch, Debbie Riddell, Jennifer J. Walls and J. Stephen Dumler

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 6, pages 862-870
Published in print March 2001 | ISSN: 1058-4838
Published online March 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/319350
Serial Measurements of Hematologic Counts during the Active Phase of Human Granulocytic Ehrlichiosis

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To describe the changes that occur in blood count parameters during the natural course of human granulocytic ehrlichiosis, we designed a retrospective cross-sectional case study of 144 patients with human granulocytic ehrlichiosis and matched controls who had a different acute febrile illness. Patients from New York State and the upper Midwest were evaluated from June 1990 through December 1998. Routine complete blood counts and manual differential leukocyte counts of peripheral blood were performed on blood samples that were collected during the active illness, and values were recorded until the day of treatment with an active antibiotic drug. Thrombocytopenia was observed more frequently than was leukopenia, and the risk of having ehrlichiosis varied inversely with the granulocyte count and the platelet count. Patients with ehrlichiosis displayed relative and absolute lymphopenia and had a significant increase in band neutrophil counts during the first week of illness. Knowledge of characteristic complete blood count patterns that occur during active ehrlichiosis may help clinicians to identify patients who should be evaluated specifically for ehrlichiosis and who should receive empiric antibiotic treatment with doxycycline.

Journal Article.  5764 words.  Illustrated.

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

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