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Ehrlichia chaffeensis in child, Venezuela.

Martínez MC, Gutiérrez CN, Monger F, Ruiz J, Watts A, Mijares VM, Rojas MG, Triana-Alonso FJ - Emerging Infect. Dis. (2008)

View Article: PubMed Central - PubMed

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Serologic studies have indicated E. chaffeensis infection in Latin American countries: Venezuela, Mexico, Argentina, Chile, and Brazil... At the time of physical examination, the patient appeared acutely ill with fever (41°C), dehydration, somnolence, conjunctivitis, facial edema, cervical adenomegaly, soft depressible abdomen painful to palpation, and hepatomegaly... Cardiopulmonary examination found regular cardiac sounds with systolic tricuspid murmur and abnormal bilateral respiratory sounds (rhonchi)... Starting on the first day of hospitalization, the patient was treated with doxycycline (14 days) and chloramphenicol (8 days)... After 24 hours, malaise, headache, facial edema, and conjunctivitis improved... Ultrasonographic images of the abdomen indicated acute cholecystitis and hepatosplenomegaly; endoscopic examination of the upper digestive tract showed hyperplasia, hyperemia, and linear and pseudomembranous lacerations in the middle and distal thirds of the esophagus (Mallory-Weiss syndrome) and moderate erythema of the stomach... Test results for Helicobacter pylori and Giardia lamblia were negative... Laboratory results showed leukopenia and monocytosis on day 5 of illness... AST levels increased on day 5 and peaked (215 IU) on day 7... Both values decreased progressively to reference levels (after 25 days for ALT and 46 days for AST)... This report provides molecular evidence of E. chaffeensis infection in a patient with acute disease in Venezuela... E. canis in an asymptomatic patient in Venezuela has been demonstrated by PCR and culture isolation and was recently demonstrated in symptomatic patients... The positive anti-dengue IgM and the seroconversion of the IgG together with the negative PCR and isolation results suggest a recent, inactive infection with dengue virus... Although Amblyomma americanum, the main known vector of E. chaffeensis, has not been reported in Venezuela, Rhipicephalus sanguineus and A. cajennense are abundant in rural areas of Venezuela; their ability to be vectors should be investigated.

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Peripheral blood smears (buffy-coat preparation) showing variable-sized basophilic inclusions (arrows) in mononuclear cells from a 9-year-old boy with human monocytic ehrlichiosis, Carabobo, Venezuela. Dip Quick (Jorgensen Laboratories, Inc., Loveland, CO, USA) staining; magnification ×1,000.
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Figure 1: Peripheral blood smears (buffy-coat preparation) showing variable-sized basophilic inclusions (arrows) in mononuclear cells from a 9-year-old boy with human monocytic ehrlichiosis, Carabobo, Venezuela. Dip Quick (Jorgensen Laboratories, Inc., Loveland, CO, USA) staining; magnification ×1,000.

Mentions: The buffy-coat smear performed 4 days after illness onset showed basophilic intracytoplasmic inclusions inside vacuoles of lymphocytes and monocytes, with typical features of morulae reported for human monocytic ehrlichiosis (Figure). Nested PCR analysis was positive for E. chaffeensis, and sequencing of the amplified DNA fully confirmed the 16S rRNA targeted sequence.


Ehrlichia chaffeensis in child, Venezuela.

Martínez MC, Gutiérrez CN, Monger F, Ruiz J, Watts A, Mijares VM, Rojas MG, Triana-Alonso FJ - Emerging Infect. Dis. (2008)

Peripheral blood smears (buffy-coat preparation) showing variable-sized basophilic inclusions (arrows) in mononuclear cells from a 9-year-old boy with human monocytic ehrlichiosis, Carabobo, Venezuela. Dip Quick (Jorgensen Laboratories, Inc., Loveland, CO, USA) staining; magnification ×1,000.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2570823&req=5

Figure 1: Peripheral blood smears (buffy-coat preparation) showing variable-sized basophilic inclusions (arrows) in mononuclear cells from a 9-year-old boy with human monocytic ehrlichiosis, Carabobo, Venezuela. Dip Quick (Jorgensen Laboratories, Inc., Loveland, CO, USA) staining; magnification ×1,000.
Mentions: The buffy-coat smear performed 4 days after illness onset showed basophilic intracytoplasmic inclusions inside vacuoles of lymphocytes and monocytes, with typical features of morulae reported for human monocytic ehrlichiosis (Figure). Nested PCR analysis was positive for E. chaffeensis, and sequencing of the amplified DNA fully confirmed the 16S rRNA targeted sequence.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Serologic studies have indicated E. chaffeensis infection in Latin American countries: Venezuela, Mexico, Argentina, Chile, and Brazil... At the time of physical examination, the patient appeared acutely ill with fever (41°C), dehydration, somnolence, conjunctivitis, facial edema, cervical adenomegaly, soft depressible abdomen painful to palpation, and hepatomegaly... Cardiopulmonary examination found regular cardiac sounds with systolic tricuspid murmur and abnormal bilateral respiratory sounds (rhonchi)... Starting on the first day of hospitalization, the patient was treated with doxycycline (14 days) and chloramphenicol (8 days)... After 24 hours, malaise, headache, facial edema, and conjunctivitis improved... Ultrasonographic images of the abdomen indicated acute cholecystitis and hepatosplenomegaly; endoscopic examination of the upper digestive tract showed hyperplasia, hyperemia, and linear and pseudomembranous lacerations in the middle and distal thirds of the esophagus (Mallory-Weiss syndrome) and moderate erythema of the stomach... Test results for Helicobacter pylori and Giardia lamblia were negative... Laboratory results showed leukopenia and monocytosis on day 5 of illness... AST levels increased on day 5 and peaked (215 IU) on day 7... Both values decreased progressively to reference levels (after 25 days for ALT and 46 days for AST)... This report provides molecular evidence of E. chaffeensis infection in a patient with acute disease in Venezuela... E. canis in an asymptomatic patient in Venezuela has been demonstrated by PCR and culture isolation and was recently demonstrated in symptomatic patients... The positive anti-dengue IgM and the seroconversion of the IgG together with the negative PCR and isolation results suggest a recent, inactive infection with dengue virus... Although Amblyomma americanum, the main known vector of E. chaffeensis, has not been reported in Venezuela, Rhipicephalus sanguineus and A. cajennense are abundant in rural areas of Venezuela; their ability to be vectors should be investigated.

Show MeSH
Related in: MedlinePlus