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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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