Journal Article

Infections with <i>Ehrlichia chaffeensis</i> and <i>Ehrlichia ewingii</i> in Persons Coinfected with Human Immunodeficiency Virus

Christopher D. Paddock, Scott M. Folk, G. Merrill Shore, Linda J. Machado, Mark M. Huycke, Leonard N. Slater, Allison M. Liddell, Richard S. Buller, Gregory A. Storch, Thomas P. Monson, David Rimland, John W. Sumner, Joseph Singleton, Karen C. Bloch, Yi-Wei Tang, Steven M. Standaert and James E. Childs

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 9, pages 1586-1594
Published in print November 2001 | ISSN: 1058-4838
Published online November 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/323981
Infections with Ehrlichia chaffeensis and Ehrlichia ewingii in Persons Coinfected with Human Immunodeficiency Virus

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The clinical course and laboratory evaluation of 21 patients coinfected with human immunodeficiency virus (HIV) and Ehrlichia chaffeensis or Ehrlichia ewingii are reviewed and summarized, including 13 cases of ehrlichiosis caused by E. chaffeensis, 4 caused by E. ewingii, and 4 caused by either E. chaffeensis or E. ewingii. Twenty patients were male, and the median CD4+ T lymphocyte count was 137 cells/μL. Exposures to infecting ticks were linked to recreational pursuits, occupations, and peridomestic activities. For 8 patients, a diagnosis of ehrlichiosis was not considered until ⩾4 days after presentation. Severe manifestations occurred more frequently among patients infected with E. chaffeensis than they did among patients infected with E. ewingii, and all 6 deaths were caused by E. chaffeensis. Ehrlichiosis may be a life-threatening illness in HIV-infected persons, and the influence of multiple factors, including recent changes in the epidemiology and medical management of HIV infection, may increase the frequency with which ehrlichioses occur in this patient cohort.

Journal Article.  5972 words.  Illustrated.

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

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