Clinical and Epidemiological Features of Early Lyme Disease and Human Granulocytic Ehrlichiosis in Wisconsin

To compare clinical features and assess risk factors for human granulocytic ehrlichiosis (HGE) and early Lyme disease, we enrolled patients in a case-control study during the 1996 and 1997 tick seasons. Clinical and demographic characteristics were assessed for patients with laboratory-confirmed cas...

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Bibliographic Details
Published in:Clinical infectious diseases 1999-12, Vol.29 (6), p.1472-1477
Main Authors: Belongia, Edward A., Reed, Kurt D., Mitchell, Paul D., Chyou, Po-Huang, Mueller-Rizner, Nancy, Finkel, Michael F., Schriefer, Martin E.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Bacterial diseases
Biological and medical sciences
Bites and stings
Borrelia burgdorferi
Borrelia infections
Camping
Case-Control Studies
Clinical Articles
Coinfection
Diagnosis, Differential
Diseases
Ehrlichia
Ehrlichiosis
Ehrlichiosis - epidemiology
Ehrlichiosis - pathology
Erythema
Female
Human bacterial diseases
human granulocytic ehrlichiosis
Humans
Infections
Infectious diseases
Logistic Models
Lyme disease
Lyme Disease - epidemiology
Lyme Disease - pathology
Male
Medical sciences
Middle Aged
Multivariate Analysis
Predisposing factors
Risk Factors
Rural Population
Ticks
Tropical bacterial diseases
USA, Wisconsin
Wisconsin - epidemiology
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Summary:To compare clinical features and assess risk factors for human granulocytic ehrlichiosis (HGE) and early Lyme disease, we enrolled patients in a case-control study during the 1996 and 1997 tick seasons. Clinical and demographic characteristics were assessed for patients with laboratory-confirmed cases of HGE or Lyme disease, and risk factors were compared with those of matched control subjects. We identified 83 persons with Lyme disease, 27 with HGE, and 11 with apparent coinfection. Unsuspected Ehrlichia infection was identified in 8 (13%) of 60 patients with Lyme disease. Patients with HGE were older and more likely to have fever, chills, or dyspnea than were those with Lyme disease only. Most patients with apparent coinfection did not have hematologic abnormalities. In the risk factor analysis, tickborne illness was independently associated with rural residence and camping. The clinical spectrum of HGE overlaps that of Lyme disease, and physicians in areas of endemicity should consider both diseases in treating patients with a compatible rash or febrile illness.
ISSN:1058-4838
1537-6591
DOI:10.1086/313532