More about human monocytotropic ehrlichiosis in Brazil: serological evidence of nine new cases

Abstract

Human Ehrlichia chaffeensis infections have been reported in North America, Asia and Europe, but only recently have human cases been reported in Brazil. Nine new human cases of E. chaffeensis infection diagnosed on a clinical and serological basis are reported. Serological tests were performed with indoor slides prepared with CDC stock DH-82 cells infected with E. chaffeensis (Arkansas strain). All but two patients were adults. Seven patients were male and two female. The fever duration varied from 4 to 120 days with a median of 6 days. All patients recalled previous tick attack. IgM was detected in four cases. Influenza like syndrome was the most frequent clinical form affecting five patients. Two patients had fever of unknown origin (FUO), one patient had blood culture-negative endocarditis and one had encephalitis. All patients except one recovered. Two patients were correctly treated. One patient with FUO had AIDS and unexplained pancytopenia. The occurrence of human ehrlichiosis by E. chaffeensis remains to be proved in Brazil; the cases reported here highlight the possibility of such disease occurrence in Brazil.

Ehrlichiosis in Brazil

“…HME and HGE have been described worldwide (OTEO et al, 2000;GUILLAUME et al, 2002;GARDNER et al, 2003;RUSCIO;CINCO, 2003;MASTRANDREA et al, 2006). Three human ehrlichiosis cases have been serologically identified as HME in Brazil since 1980(CALIC et al, 2004COSTA et al, 2005COSTA et al, , 2006 but molecular confirmation has not been performed. The disease in humans has been suggested serologically in other South American countries including Argentina (RIPOLL et al, 1999), Chile (LÓPEZ et al, 2003) and Peru (MORO et al, 2009).…”

Molecular Detection ofEhrlichia chaffeensisinAmblyomma parvumTicks, Argentina

“…With the increase of income and living standards, and the pursuit of exotic and delicate foods, populations around the world have seen angiostrongyliasis become an important foodborne parasitic zoonosis (1)(2)(3)(4)(5)(6)(7)(8)(9).…”

Survey for Tick-Borne Zoonoses in the State of Espirito Santo, Southeastern Brazil

“…14,15 Human cases of ehrlichiosis in Brazil were only reported by clinical suspects and serological tests, with no DNA amplification and further identification of the agent. 16,17 Babesiosis is a common tick-borne disease of dogs and horses in Brazil. Babesia canis vogeli (= B. vogeli ) is the most common agent affecting dogs, although there are a few reports of Babesia gibsoni .…”