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Title: The first report of human illness associated with the Panola Mountain Ehrlichia species: a case report

Author
item Reeves, Will
item LOFTIS, AMANDA - PRIVATE CITIZEN
item NICHOLSON, WILLIAM - CTR. FOR DISEASE CONTROL
item CZARKOWSKI, ALLEN - CTR. FOR DISEASE CONTROL

Submitted to: Journal of Medical Case Reports
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/18/2008
Publication Date: 4/30/2008
Citation: Reeves, W.K., Loftis, A.D., Nicholson, W.L., Czarkowski, A.G. 2008. Acute Illness Associated with Ehrlichia SP P-MTN from Atlanta GA, USA: A Case Report. Journal of Medical Case Reports. Vol. 2:139.

Interpretive Summary: We describe previously unknown tick-borne disease was diagnosed in a person. We highlight the need for rapid diagnosis of tick-borne disease and demonstrated that PCR is more reliable than serology for diagnosis of this disease.

Technical Abstract: Introduction: Two species of Ehrlichia are known to cause human illness. Several other species have been discovered in ticks and animals, and recent reports suggest that some of these Ehrlichia species might be human pathogens. We report here the first association of a recently discovered pathogen, the Panola Mountain Ehrlichia species with a case of human illness. Case presentation: A 31-year-old man from Atlanta, Georgia (GA) in the United States of America (USA) presented with a persistent sore neck of 3 weeks duration following a tick bite. DNA from the Panola Mountain Ehrlichia species which was recently discovered in a goat in Georgia, was detected in an acute blood sample. Serologic testing was inconclusive. Polymerase chain reaction tests for other tick-borne diseases found in this region were negative. The patient rapidly improved in response to doxycycline therapy. Conclusions: Detection of Ehrlichia DNA in an acute blood sample meets the Centers for Disease Control and Prevention laboratory confirmation criteria for ehrlichiosis, and response to doxycycline provides supporting clinical evidence. The Panola Mountain Ehrlichia species an emerging pathogen transmitted by ticks in the eastern USA, should be considered as a possible cause of tick-borne illness in this region.