Human Monocytotropic Ehrlichiosis, Missouri

Juan P. Olano, Edwin Masters, Wayne Hogrefe, David H. Walker

Research output: Contribution to journalArticlepeer-review

64 Scopus citations


To determine the incidence, clinical and laboratory characteristics, and utility of molecular diagnosis of human monocytotropic ehrlichiosis (HME) in the primary care setting, we conducted a prospective study in an outpatient primary care clinic in Cape Girardeau, Missouri. One hundred and two patients with a history of fever for 3 days (>37.7°C), tick bite or exposure, and no other infectious disease diagnosis were enrolled between March 1997 and December 1999. HME was diagnosed in 29 patients by indirect immunofluorescent antibody assay and polymerase chain reaction (PCR). Clinical and laboratory manifestations included fever (100%), headache (72%), myalgia or arthralgia (69%), chills (45%), weakness (38%), nausea (38%), leukopenia (60%), thrombocytopenia (56%), and elevated aspartate aminotransferase level (52%). Hospitalization occurred in 41% of case-patients. PCR sensitivity was 56%; specificity, 100%. HME is a prevalent, potentially severe disease in southeastern Missouri that often requires hospitalization. Because clinical presentation of HME is nonspecific, PCR is useful in the diagnosis of acute HME.

Original languageEnglish (US)
Pages (from-to)1579-1586
Number of pages8
JournalEmerging infectious diseases
Issue number12
StatePublished - Dec 2003

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


Dive into the research topics of 'Human Monocytotropic Ehrlichiosis, Missouri'. Together they form a unique fingerprint.

Cite this