Emergence of a new pathogenic Ehrlichia species, Wisconsin and Minnesota, 2009.
Emergence of a new pathogenic Ehrlichia species, Wisconsin and Minnesota, 2009.
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DOI：
10.1056/nejmoa1010493
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发表时间：
2011-08-04
期刊：
影响因子：
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通讯作者：
Eremeeva ME
中科院分区：
文献类型：
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作者：
Pritt BS;Sloan LM;Johnson DK;Munderloh UG;Paskewitz SM;McElroy KM;McFadden JD;Binnicker MJ;Neitzel DF;Liu G;Nicholson WL;Nelson CM;Franson JJ;Martin SA;Cunningham SA;Steward CR;Bogumill K;Bjorgaard ME;Davis JP;McQuiston JH;Warshauer DM;Wilhelm MP;Patel R;Trivedi VA;Eremeeva ME
埃利希体病是临床上重要的新型人畜共患病。在美国，只有沙菲埃利体和伊温伊氏埃利体被认为会引起人类的埃利体病。疑似埃立克体病的患者常规接受检查，以确保正确诊断并确定病因。我们使用分子方法，培养和血清学检测来诊断和确定埃利希体病病例的病因。经检测，在明尼苏达州和威斯康星州发现的4例埃利希体病并非来自沙非伊蚊或伊温伊蚊，而是由一种新发现的埃利希体引起的。所有患者均有发热、不适、头痛和淋巴细胞减少；3例有血小板减少症；其中两人的肝酶水平升高。均经强力霉素治疗后痊愈。在明尼苏达州或威斯康星州收集的697只肩胛硬蜱中，至少有17只在聚合酶链反应检测中呈同种埃利希体阳性。遗传分析表明，该新种与鼠伊氏体亲缘关系较近。我们在明尼苏达州和威斯康星州报道了一种新的埃利希体，并提供了支持性的临床、流行病学、培养、dna序列和载体数据。医生需要意识到这种新发现的鼠性大肠杆菌的近亲，以确保适当的检测、治疗和区域监测。（由美国国立卫生研究院和疾病控制与预防中心资助。）
Ehrlichiosis is a clinically important, emerging zoonosis. Only Ehrlichia chaffeensis and E. ewingii have been thought to cause ehrlichiosis in humans in the United States. Patients with suspected ehrlichiosis routinely undergo testing to ensure proper diagnosis and to ascertain the cause. We used molecular methods, culturing, and serologic testing to diagnose and ascertain the cause of cases of ehrlichiosis. On testing, four cases of ehrlichiosis in Minnesota or Wisconsin were found not to be from E. chaffeensis or E. ewingii and instead to be caused by a newly discovered ehrlichia species. All patients had fever, malaise, headache, and lymphopenia; three had thrombocytopenia; and two had elevated liver-enzyme levels. All recovered after receiving doxycycline treatment. At least 17 of 697 Ixodes scapularis ticks collected in Minnesota or Wisconsin were positive for the same ehrlichia species on polymerase-chain-reaction testing. Genetic analyses revealed that this new ehrlichia species is closely related to E. muris. We report a new ehrlichia species in Minnesota and Wisconsin and provide supportive clinical, epidemiologic, culture, DNA-sequence, and vector data. Physicians need to be aware of this newly discovered close relative of E. muris to ensure appropriate testing, treatment, and regional surveillance. (Funded by the National Institutes of Health and the Centers for Disease Control and Prevention.)