Unexplained Febrile Illnesses After Exposure to Ticks

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Abstract
TheEhrlichiaare tick-borne rickettsial organisms that cause disease in animals throughout the world but that have been previously recognized as human pathogens only in Asia. We have identified six patients with serological evidence of recent infection with anEhrlichia:a fourfold or greater rise or fall in titer toEhrlichiacanis. All of the patients reported recent tick bites. Rigors, myalgia, headache, nausea, and anorexia were each reported by five patients. Fever was present in all patients and was accompanied by relative bradycardia and leukopenia in five patients, thrombocytopenia and abnormal liver function test results in four, and anemia in three. Five of the six patients were treated with tetracycline hydrochloride, and all recovered. Infection withEhrlichiashould be considered in patients with unexplained febrile illnesses after tick exposure. (JAMA1987;257:3100-3104)