Human granulocytic ehrlichiosis in a renal transplant patient: Case report and review of the literature

Background. Human ehrlichiosis, a newly described zoonotic infection, can be classified as human monocytic ehrlichiosis (HME) or human granulocytic ehrlichiosis (HGE). Although the clinical manifestations of HME and HGE are similar, the type of leukocyte infected, the etiologic agent, and the tick vector are distinct. Methods. We report the first case of HGE in a solid organ transplant recipient and review the literature on HGE. Results. Our patient displayed typical epidemiological, clinical, and laboratory features and responded promptly to therapy with doxycycline. Conclusions. Although opportunistic infections are relatively common in the posttransplant population, one must always consider other infections that occur in normal hosts as well. Human ehrlichiosis should be included in the differential diagnosis for transplant patients with fever, cytopenias, and hepatitis, especially if exposure to ticks in endemic areas has occurred.