Ehrlichiosis presenting as a life-threatening illness

Tal, Alexander; Shannahan, Dawn

doi:10.1016/s0002-9343(99)80388-x

Cited by 8 publications

(5 citation statements)

References 1 publication

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“…In some patients, untreated disease may progress to death as early as the second week of illness (79,109,179,209) or may cause a febrile illness lasting 2 to 3 weeks (106). Multisystem involvement often develops in patients with severe disease and may include acute renal failure, metabolic acidosis, respiratory failure, profound hypotension, disseminated intravascular coagulopathy, hepatic failure, adrenal insufficiency, and myocardial dysfunction (103,138,174,177,179,194,206,246,254,261,279). The factors responsible for disease severity and involvement of specific organ systems are incompletely understood.…”

Section: Characteristics Of Diseasementioning

confidence: 99%

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Ehrlichia chaffeensis: a Prototypical Emerging Pathogen

2003

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Ehrlichia chaffeensis is an obligately intracellular, tick-transmitted bacterium that is maintained in nature in a cycle involving at least one and perhaps several vertebrate reservoir hosts. The moderate to severe disease caused by E. chaffeensis in humans, first identified in 1986 and reported for more than 1,000 patients through 2000, represents a prototypical “emerging infection.” Knowledge of the biology and natural history of E. chaffeensis, and of the epidemiology, clinical features, and laboratory diagnosis of the zoonotic disease it causes (commonly referred to as human monocytic ehrlichiosis [HME]) has expanded considerably in the period since its discovery. In this review, we summarize briefly the current understanding of the microbiology, pathogenesis, and clinical manifestations associated with this pathogen but focus primarily on discussing various ecological factors responsible for the recent recognition of this important and potentially life-threatening tick-borne disease. Perhaps the most pivotal element in the emergence of HME has been the staggering increases in white-tailed deer populations in the eastern United States during the 20th century. This animal serves as a keystone host for all life stages of the principal tick vector (Amblyomma americanum) and is perhaps the most important vertebrate reservoir host for E. chaffeensis. The contributions of other components, including expansion of susceptible human populations, growth and broadening geographical distributions of other potential reservoir species and A. americanum, and improvements in confirmatory diagnostic methods, are also explored

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Section: Characteristics Of Diseasementioning

confidence: 99%

“…Patients may develop profound thrombocytopenia and coagulopathies and occasionally develop hemorrhagic manifestations including epistaxsis (208), pulmonary hemorrhage (89,109,180,208), gastrointestinal bleeding (1,89,174,263,275), subdural hematomas (180,206), hematuria (263), and conjunctival hemorrhage (27,103,173,261).…”

Section: Characteristics Of Diseasementioning

confidence: 99%

Ehrlichia chaffeensis: a Prototypical Emerging Pathogen

2003

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“…Southern blotting. The groEL analog heat shock protein gene of E. chaffeensis had been cloned by the same approaches as those used in this study (30). It was suspected that some of our clones would contain the heat shock protein gene.…”

Section: Methodsmentioning

confidence: 99%

“…Hematologic and clinical chemistry laboratory results typically include leukopenia, thrombocytopenia, and elevated levels of hepatic enzymes in serum (20). HME is a moderate-to-severe illness, even lifethreatening in some cases (18,26,30). The disease was first reported in the United States in 1987 (19,23).…”

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confidence: 99%

Comparison of Ehrlichia chaffeensis Recombinant Proteins for Serologic Diagnosis of Human Monocytotropic Ehrlichiosis

Crocquet‐Valdes

Cullman³

et al. 1999

J Clin Microbiol

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Diagnosis of human monocytotropic ehrlichiosis (HME) generally depends on serology that detects the antibody response to immunodominant proteins of Ehrlichia chaffeensis. Protein immunoblotting was used to evaluate the reaction of the antibodies in patients’ sera with the recombinant E. chaffeensis 120- and 28-kDa proteins as well as the 106- and the 37-kDa proteins. The cloning of the genes encoding the latter two proteins is described in this report. Immunoelectron microscopy demonstrated that the 106-kDa protein is located at the surfaces of ehrlichiae and on the intramorular fibrillar structures associated with E. chaffeensis. The 37-kDa protein is homologous to the iron-binding protein of gram-negative bacteria. Forty-two serum samples from patients who were suspected to have HME were tested by immunofluorescence (IFA) using E. chaffeensis antigen and by protein immunoblotting using recombinant E. chaffeensisproteins expressed in Escherichia coli. Thirty-two serum samples contained IFA antibodies at a titer of 1:64 or greater. The correlation of IFA and recombinant protein immunoblotting was 100% for the 120-kDa protein, 41% for the 28-kDa protein, 9.4% for the 106-kDa protein, and 0% for the 37-kDa protein. None of the recombinant antigens yielded false-positive results. All the sera reactive with the recombinant 28- or the 106-kDa proteins also reacted with the recombinant 120-kDa protein.

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“…Human monocytic ehrlichiosis (HME) is a newly emerging tick‐borne infectious disease caused by Ehrlichia chaffeensis [1,2]. HME is a moderate to severe illness, life‐threatening in some cases with a case fatality rate of 3%[3–8]. E. chaffeensis is an obligatory intracellular bacterium, which resides in an early‐endosomal vacuole primarily in the monocytes and macrophages [9].…”

Section: Introductionmentioning

confidence: 99%

L-selectin and E-selectin expressed on monocytes mediatingEhrlichia chaffeensisattachment onto host cells

Zhang

McBride

2003

FEMS Microbiology Letters

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Ehrlichia chaffeensis, the agent of human monocytic ehrlichiosis, is an obligatory intracellular bacterium that exhibits monocytic host cell tropism. Ehrlichiae must enter the host cell, and then establish infection. The tropism of E. chaffeensis for monocytes suggests that the cell contains some specific surface components that mediate E. chaffeensis attachment and entry into host cells. In this study, host cell surface components that play a role in ehrlichial attachment were identified using a human monocyte/macrophage cell line, THP-1. E. chaffeensis attachment to THP-1 cells was partially blocked in the presence of antibodies to E-selectin and L-selectin, but not by antibodies to P-selectin, integrin alpham, integrin alphax, or normal mouse IgG as determined by real time polymerase chain reaction. Conversely, in HeLa cells that do not exhibit surface expression of E-selectin and L-selectin, antibodies to these cell surface proteins did not inhibit E. chaffeensis attachment. These findings indicate that E-selectin and L-selectin are cell surface proteins that might act as co-receptors and contribute to E. chaffeensis attachment and entry into THP-1.

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Ehrlichiosis presenting as a life-threatening illness

Cited by 8 publications

References 1 publication

Ehrlichia chaffeensis: a Prototypical Emerging Pathogen

Ehrlichia chaffeensis: a Prototypical Emerging Pathogen

Comparison of Ehrlichia chaffeensis Recombinant Proteins for Serologic Diagnosis of Human Monocytotropic Ehrlichiosis

L-selectin and E-selectin expressed on monocytes mediatingEhrlichia chaffeensisattachment onto host cells

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