Transmission of Human Granulocytic Ehrlichiosis

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Abstract
To the Editor. —The recent discovery of human granulocytic ehrlichiosis (HGE) in Wisconsin and Minnesota1,2 is highly significant because it alerts physicians to the presence of a potentially fatal but generally treatable disease. Our recent experiences support the described clinical presentations of the disease, and the following case report provides preliminary evidence that Ixodes scapularis is a vector of HGE. In the fall of 1993, a 57-year-old man who resided in central Wisconsin presented to his personal physician with a temperature of 40°C, severe chills, and myalgias. The patient had recently returned from a visit to northwestern Wisconsin. On physical examination of the patient, the physician found an engorged tick, identified as an adult female I scapularis, slightly embedded in the patient's back. Treatment was initiated with doxycycline, and dramatic improvement in the patient's condition was noted within 48 hours. To date, there has not been a recurrence of

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