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

• Published in: Transplant infectious disease Vol. 19; no. 2
• Main Authors: Regunath, Hariharan, Rojas‐Moreno, Christian, Olano, Juan P., Hammer, Richard D., Salzer, William
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01-04-2017
• Subjects: Aged; Animals; Anti-Bacterial Agents - therapeutic use; blood smear; Cytodiagnosis - methods; Disease Transmission, Infectious; DNA, Bacterial - isolation & purification; doxycycline; Doxycycline - therapeutic use; Early Diagnosis; Ehrlichia - isolation & purification; Ehrlichia ewingii; Ehrlichiosis - blood; Ehrlichiosis - diagnosis; Ehrlichiosis - drug therapy; Ehrlichiosis - microbiology; Female; fever; Fever - blood; Fever - diagnosis; Fever - drug therapy; Fever - microbiology; Graft Rejection - drug therapy; Humans; Immunosuppression - adverse effects; Immunosuppression - methods; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Ixodidae - microbiology; Leukopenia - blood; lung transplant; 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; fever; doxycycline; lung transplant; blood smear; Ehrlichia ewingii
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/tid.12652

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.