Early diagnosis of Ehrlichia ewingii infection in a lung transplant recipient by peripheral blood smear

Transpl Infect Dis. 2017 Apr;19(2). doi: 10.1111/tid.12652. Epub 2017 Feb 15.

Abstract

Ehrlichiosis in lung transplant (LT) recipients is associated with severe outcomes. Ehrlichia ewingii is a less frequent cause of symptomatic ehrlichiosis, characterized by cytoplasmic inclusions (morulae) within circulating neutrophils. We report a case of E. ewingii infection in an LT recipient diagnosed promptly by blood smear exam and confirmed with molecular studies.

Keywords: Ehrlichia ewingii; blood smear; doxycycline; fever; lung transplant.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Animals
  • Anti-Bacterial Agents / therapeutic use*
  • Cytodiagnosis / methods
  • DNA, Bacterial / isolation & purification
  • Disease Transmission, Infectious
  • Doxycycline / therapeutic use
  • Early Diagnosis
  • Ehrlichia / isolation & purification*
  • Ehrlichiosis / blood
  • Ehrlichiosis / diagnosis*
  • Ehrlichiosis / drug therapy
  • Ehrlichiosis / microbiology
  • Female
  • Fever / blood
  • Fever / diagnosis*
  • Fever / drug therapy
  • Fever / microbiology
  • Graft Rejection / drug therapy*
  • Humans
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Ixodidae / microbiology
  • Leukopenia / blood
  • Lung Transplantation / adverse effects*
  • Mycophenolic Acid / adverse effects
  • Mycophenolic Acid / therapeutic use
  • Neutrophils / microbiology*
  • Polymerase Chain Reaction
  • Prednisone / adverse effects
  • Prednisone / therapeutic use
  • Tacrolimus / adverse effects
  • Tacrolimus / therapeutic use
  • Thoracentesis
  • Thrombocytopenia / blood
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Immunosuppressive Agents
  • Mycophenolic Acid
  • Doxycycline
  • Prednisone
  • Tacrolimus