Ehrlichia chaffeensis: a prevalent, life-threatening, emerging pathogen.

David Walker, Nahed Ismail, Juan Olano, Jere McBride, Xue Jie Yu, Hui Min Feng

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24 Citations (Scopus)

Abstract

Ehrlichia chaffeensis are small, obligately intracellular, endosomal bacteria with tropism for macrophages. Persistent infection in reservoir white-tailed deer is transmitted by lone star ticks. Flu-like illness can progress to severe multisystem disease with toxic shock-like syndrome, meningitis, or ARDS. The case-fatality rate is 2.7%. Leukopenia and thrombocytopenia are diagnostically useful. Granulomas are associated with control of the infection. Ehrlichial proteins and glycoproteins have been sequenced and expressed for diagnostic serology and vaccine development. Mouse models (mild disease and persistent infection with E. muris and fatal monocytotropic ehrlichiosis with a Japanese tick isolate) revealed that CD4 and CD8 T type 1 lymphocyte responses, IFN-gamma, TNF-alpha, and antibodies play roles in protective immunity, while a weak CD4 T-helper response, overproduction of TNF-alpha, and very high IL-10 are associated with toxic shock-like mortality. Protection against fatal ehrlichiosis was achieved by prior infection with low virulence E. muris. Acute clinical diagnosis is difficult except by PCR. Response to doxycycline is dramatic.

Original languageEnglish (US)
JournalTransactions of the American Clinical and Climatological Association
Volume115
StatePublished - 2004

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Ehrlichia chaffeensis
Ehrlichiosis
Ticks
Septic Shock
Tumor Necrosis Factor-alpha
Infection
Tropism
Deer
Mortality
Doxycycline
Leukopenia
Serology
Infection Control
Granuloma
Meningitis
Thrombocytopenia
Interleukin-10
Virulence
Immunity
Glycoproteins

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Ehrlichia chaffeensis: a prevalent, life-threatening, emerging pathogen.",
abstract = "Ehrlichia chaffeensis are small, obligately intracellular, endosomal bacteria with tropism for macrophages. Persistent infection in reservoir white-tailed deer is transmitted by lone star ticks. Flu-like illness can progress to severe multisystem disease with toxic shock-like syndrome, meningitis, or ARDS. The case-fatality rate is 2.7{\%}. Leukopenia and thrombocytopenia are diagnostically useful. Granulomas are associated with control of the infection. Ehrlichial proteins and glycoproteins have been sequenced and expressed for diagnostic serology and vaccine development. Mouse models (mild disease and persistent infection with E. muris and fatal monocytotropic ehrlichiosis with a Japanese tick isolate) revealed that CD4 and CD8 T type 1 lymphocyte responses, IFN-gamma, TNF-alpha, and antibodies play roles in protective immunity, while a weak CD4 T-helper response, overproduction of TNF-alpha, and very high IL-10 are associated with toxic shock-like mortality. Protection against fatal ehrlichiosis was achieved by prior infection with low virulence E. muris. Acute clinical diagnosis is difficult except by PCR. Response to doxycycline is dramatic.",
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T2 - a prevalent, life-threatening, emerging pathogen.

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AU - Ismail, Nahed

AU - Olano, Juan

AU - McBride, Jere

AU - Yu, Xue Jie

AU - Feng, Hui Min

PY - 2004

Y1 - 2004

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