Human Ehrlichiosis

Abstract
The letter from Rynkiewicz and Liu (Jan. 27 issue)1 reports a case of human ehrlichiosis in New England. The patient was apparently infected in that region, where Amblyomma americanum (the vector of Ehrlichia chaffeensis) is not found. The diagnosis of human ehrlichiosis was suggested by the presence of morulae in polymorphonuclear leukocytes and a positive serologic test for E. chaffeensis. The world of ehrlichiosis is wide, and we believe that basing a conclusion on serologic results in atypical cases is dangerous because of the possibility of cross-reactions among ehrlichia species2. The best example is the first reported case of human ehrlichiosis in the United States,3,4 which was erroneously considered to be caused by E. canis on the basis of serologic tests and was later confirmed to be due to E. chaffeensis.

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