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A Case of Acute Monocytic Ehrlichiosis with Prominent Neurologic Signs
Neurol 48:1619-1623, Grant,A.C.,et al, 1997
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Article Abstract
Human monocytic ehrlichiosis is a recently described tick borne infection with the rickettsial organism Erlichia chaffeensis.We describe a patient with documented E chafeensis infection and multiple organ system involvement.Prominent neurologic symptoms and signs included severe headache,meningismus,and altered mental status.Additional neurologic findings included unilateral arm weakness and a Bell's Palsy.Biopsy of the brain and meninges demonstrated an infiltrate of atypical lymphoid cells in the leptomeninges with involvement of blood vessel walls and extension into the Virchow-Robin spaces.Bone marrow biopsy revealed fibrin-ringed granulomas.The patient also developed a nonspecific increase in immunoglobulin production.Host immune response may play a critical role in the pathophysiology of ehrlichiosis.
 
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aspartate aminotransferase
bone marrow biopsy
brain biopsy
BUN,elevated
ehrlichiosis
facial nerve palsy
fever
headache
liver function enzymes
meningismus
mental status,abnormal
pancytopenia
rickettsial organism
tick bite
treatment of neurologic disorder

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