Serial measurements of hematologic counts during the active phase of human granulocytic ehrlichiosis

Johan S. Bakken, Maria E. Aguero-Rosenfeld, Robert L. Tilden, Gary P. Wormser, Harold W. Horowitz, John T. Raffalli, Mehdi Baluch, Debbie Riddell, Jennifer J. Walls, J. Stephen Dumler

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100 Scopus citations


To describe the changes that occur in blood count parameters during the natural course of human granulocytic ehrlichiosis, we designed a retrospective cross-sectional case study of 144 patients with human granulocytic ehrlichiosis and matched controls who had a different acute febrile illness. Patients from New York State and the upper Midwest were evaluated from June 1990 through December 1998. Routine complete blood counts and manual differential leukocyte counts of peripheral blood were performed on blood samples that were collected during the active illness, and values were recorded until the day of treatment with an active antibiotic drug. Thrombocytopenia was observed more frequently than was leukopenia, and the risk of having ehrlichiosis varied inversely with the granulocyte count and the platelet count. Patients with ehrlichiosis displayed relative and absolute lymphopenia and had a significant increase in band neutrophil counts during the first week of illness. Knowledge of characteristic complete blood count patterns that occur during active ehrlichiosis may help clinicians to identify patients who should be evaluated specifically for ehrlichiosis and who should receive empiric antibiotic treatment with doxycycline.

Original languageEnglish (US)
Pages (from-to)862-870
Number of pages9
JournalClinical Infectious Diseases
Issue number6
StatePublished - Mar 15 2001
Externally publishedYes

Bibliographical note

Funding Information:
Grant support: Duluth Clinic Foundation (grant 050-9939-7118) and National Institute of Allergic and Infectious Disease (grant R01 AI 4121-01).


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