Human granulocytic ehrlichiosis presenting as facial diplegia in a 42-year-old woman

Frederick S. Lee, Frederick K. Chu, Michelle Tackley, Allan D. Wu, Alireza Atri, Michael R. Wessels

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Neurologic manifestations of human ehrlichiosis are unusual and have been described almost exclusively in human monocytic ehrlichiosis associated with Ehrlichia chaffeensis. We report here a case of a previously healthy 42-year-old woman who developed bilateral facial nerve palsies in association with infection by the agent of human granulocytic ehrlichiosis (aoHGE). The diagnosis was made by specific polymerase chain reaction amplification of aoHGE sequences from samples of the patient's blood and cerebrospinal fluid (CSF), as well as propagation of aoHGE in culture of HL60 cells inoculated with the patient's CSF. To our knowledge, this is the first report directly demonstrating the presence of aoHGE in CSF, and it underscores the importance of considering HGE in patients presenting with a nonspecific febrile illness and unexplained neurologic manifestations. HGE should also be considered in the differential diagnosis of bilateral facial palsy - a rare occurrence.

Original languageEnglish (US)
Pages (from-to)1288-1291
Number of pages4
JournalClinical Infectious Diseases
Volume31
Issue number5
DOIs
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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