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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tick-borne rickettsiae of the genus Ehrlichia have recently been recognized as a cause of human illness in the United States. In the years 1986-1988, 10 cases of ehrlichiosis were diagnosed in children in Oklahoma. Fever and headache were universal: myalgias, nausea, vomiting, and anorexia were also common. Rash was observed in six patients but was a prominent finding in only one. Leukopenia, lymphopenia, and thrombocytopenia were common laboratory abnormalities. Six patients were treated with tetracycline, three with chloramphenicol, and one was not treated with antibiotics: all recovered. The onset of illness in spring and early summer for most cases paralleled the time when Amblyomma americanum and Dermacentor variabilis are most active, suggesting that one or both ticks may be vectors of human ehrlichiosis in Oklahoma.
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PMID:Ehrlichiosis in children. 198 31

Human ehrlichiosis is a tick-borne rickettsial disease characterized by fever, headache, myalgias, anorexia, and occasionally rash. In our patient, changes in mental status, upper motor neuron signs, cerebrospinal fluid pleocytosis, and increased serum protein levels were found in association with serologically confirmed ehrlichiosis and were most likely due to vasculitis involving the central nervous system. Intraleukocytic inclusions, although observed in our case, have been infrequently found in other reported cases of ehrlichiosis.
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PMID:Neurologic abnormalities in a patient with human ehrlichiosis. 223 70

An outbreak of unexplained illness occurred in members of an army reserve unit after field training in an area of New Jersey endemic for Lyme disease. Nine (12%) of the 74 who attended the exercise had serological evidence of Ehrlichia infection, defined as a single rise in titer of antibody to Ehrlichia canis greater than or equal to 1:160 four weeks after training. Two reservists with early serum samples had documented seroconversion, defined by a four-fold or greater increase in titer of antibody to E. canis, with a peak titer of greater than or equal to 1:160. Reservists with serological evidence of Ehrlichia infection were more than three times as likely to report arthralgia, myalgia, headache, appetite loss, nausea, eye pain, and abdominal pain than the other reservists. No reservist with serological evidence of Ehrlichia infection was hospitalized and most had minimal or no symptoms. This outbreak of ehrlichiosis suggests that the usual symptoms of Ehrlichia infection are milder than previously reported and that ehrlichiosis must be considered in symptomatic persons with recent tick exposure.
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PMID:An outbreak of ehrlichiosis in members of an Army Reserve unit exposed to ticks. 291 68

Since 1986, two human tickborne diseases caused by Ehrlichia spp. have been recognized in the United States: human monocytic ehrlichiosis (HME), caused by E. chaffeensis, and human granulocytic ehrlichiosis (HGE), caused by an agent closely related to E. equi (1,2). In June 1995, the Westchester County (New York) Department of Health (WCDOH) received reports from physicians who were treating patients for suspected HGE. In response, the WCDOH sent information to all primary-care physicians in Westchester County describing the clinical and laboratory features of ehrlichiosis (fever, myalgia, headache, leukopenia, and thrombocytopenia) and requested that they voluntarily report suspected cases of ehrlichiosis. This report summarizes an investigation by the New York State Department of Health (NYSDOH) and the WCDOH of suspected ehrlichiosis cases and the clinical characteristics of confirmed and probable cases.
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PMID:Human granulocytic ehrlichiosis--New York, 1995. 766 28

Human ehrlichiosis is a newly recognized tick-borne disease. Since 1935 Ehrlichia canis has been known as a cause of illness in dogs and other canine species, and for a few years it was related with human disease. In 1990, Ehrlichia chaffeensis was isolated from a man suspected of having ehrlichiosis. Partial sequencing of the rRNAS from the human isolate and E. canis, indicated that they are 98.7% related. More recently (May 1994) an "human granulocytic ehrlichiosis" have been reported in USA. PCR amplification and sequence of 16S rDNA, showed that the human isolate was virtually identical to those reported for E. phagocytophila y E. equi, organisms that cause ehrlichiosis in rumiant and in horses. Most patients shows fever, headache, malaise, nausea or vomiting, anorexia and in a minority of cases rash is present. Some of them have complications such as pulmonary infiltrates, gastrointestinal problems, renal dysfunction or failure, hepatoesplenomegaly, neurologic abnormalities, DIC and some times death. Leucopenia, thrombocytopenia and elevated liver enzyme values have been common findings. Tetracycline and cloramphenicol have been using in adults and children as especific theraphy.
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PMID:[Human ehrlichiosis. Review]. 773 23

Ehrlichiosis is a recently described tick-borne disease characterized by headache, fever and chills, leukopenia, thrombocytopenia, and transaminase elevation. The presentation is similar to Rocky Mountain spotted fever but the rash is less frequently present in ehrlichiosis. The diagnosis is confirmed by elevated antibody titers to Ehrlichia chaffeensis or visualization of inclusions in white blood cells and the disease is easily cured with tetracyclines or chloramphenicol. Cases of ehrlichiosis are reported from southeastern, southcentral and midatlantic states. We report three cases of Ehrlichia infection acquired in Pulaski County and Fort Knox, KY during 1992-93.
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PMID:Ehrlichiosis in Kentucky. 775 3

Human ehrlichiosis is a recently described zoonosis caused by a rickettsia that infects leukocytes. Most patients have fever, headache, chills, and myalgias and develop leukopenia, thrombocytopenia, anemia, and elevations in serum hepatic aminotransferases. The cause of the peripheral leukopenia and thrombocytopenia is not known. We studied peripheral blood smears, bone marrow aspirates, and bone marrow biopsy specimens from patients with serologically proven ehrlichiosis to characterize the pathologic changes associated with leukopenia or thrombocytopenia, to detect the presence of immunohistologically demonstrable ehrlichiae, and to establish the infected host target cell(s). Specimens were obtained from 12 patients, and immunohistology for Ehrlichia chaffeensis was performed on tissue sections, aspirated bone marrow, and peripheral blood smears. Mean leukocyte and platelet counts available for nine patients were white blood cell count 3,300/microL (range, 1,100 to 10,300/microL) and platelets 61,000/microL (range, 40,000 to 82,000/microL). Findings included myeloid hyperplasia (eight cases), megakaryocytosis (seven cases), granulomas (eight cases), marrow histiocytosis (one case), myeloid hypoplasia (one case), pancellular hypoplasia (one case), and normocellular marrow (two cases). Morulae of E chaffeensis were detected in four of 10 cases examined by immunohistology. Most ehrlichiae were detected within histiocytes, although morulae were rarely present within lymphocytes. Leukopenia, thrombocytopenia, or pancytopenia apparently most often results from peripheral sequestration or destruction; however, hypoplasia of marrow elements is present occasionally. Immunohistologic demonstration of E chaffeensis offers a direct means for establishing the etiologic diagnosis. These observations show the relatively frequent occurrence of bone marrow granulomas and suggest that infection of cells of the reticuloendothelial system may participate in the pathogenesis of human ehrlichiosis.
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PMID:Human ehrlichiosis: hematopathology and immunohistologic detection of Ehrlichia chaffeensis. 849 79

Two new ehrlichial species that cause human disease have recently been identified: Ehrlichia chaffeensis and the currently unnamed agent of human granulocytic ehrlichiosis. Our objective was to review data on the clinical presentation, laboratory and epidemiological findings, therapy, and diagnostic procedures of patients with human ehrlichiosis due to E chaffeensis. From 1986 through 1994, 400 case patients were identified from 30 US states. Most patients had a nonspecific illness, characterized by fever and headache. Severe illness and death occurred, primarily in the elderly. Laboratory findings most commonly included leukopenia, thrombocytopenia, and elevated liver function test results. Antibody response was the basis for diagnosis, although polymerase chain reaction testing has been useful in research settings. Empirical treatment with tetracycline or its analogues should be begun as soon as possible after the onset of symptoms. Clinicians need to be alert for this illness when evaluating febrile patients whose history includes possible recent tick exposure.
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PMID:The interface between research and the diagnosis of an emerging tick-borne disease, human ehrlichiosis due to Ehrlichia chaffeensis. 854 43

Human ehrlichiosis is a newly emergent, tick-borne, zoonotic infection caused by members of the genus Ehrlichia. These rickettsia-like, obligate intracellular, gram-negative bacteria produce two similar yet distinct diseases. Human monocytic ehrlichiosis is caused by Ehrlichia chaffeensis. Human granulocytic ehrlichiosis is caused by an organism closely related to Ehrlichia equi. The most common initial clinical findings include fever, malaise, myalgia, headaches and rigors, while the most common laboratory findings are thrombocytopenia, leukopenia, anemia and elevated liver enzyme levels. Both diseases can produce intracytoplasmic morulae, in either monocytes or neutrophils, which may be visible on Wright-stained peripheral smears. Treatment consists of tetracycline or doxycycline. Rifampin or chloramphenicol can be tried when tetracycline is absolutely contraindicated. Treatment should never be delayed pending serologic or polymerase chain reaction confirmation of the diagnosis because of the 5 to 10 percent mortality rate.
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PMID:Human ehrlichiosis. 890 Mar 57

Two human ehrlichioses occur in the United States: human monocytic ehrlichiosis (HME), which is caused by Ehrlichia chaffeensis that infects mononuclear phagocytes in blood and tissue, and human granulocytic ehrlichiosis (HGE), an infection of granulocytes that is caused by a similar but phylogenetically distinct organism. The clinical features of both forms of human ehrlichiosis are identical and include nonspecific constitutional manifestations, such as fever, headache, malaise, nausea, vomiting, myalgia, and anorexia; however, rare patients develop neurologic symptoms and signs. Few cases of human ehrlichiosis have been described in detail, and focal neurologic deficits have only rarely been reported in such cases. We describe a patient with HME who developed a trochlear nerve paresis associated with evidence of lymphocytic meningitis during the course of her illness. We believe this to be the first well-documented case of a focal neurologic complication of human ehrlichiosis.
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PMID:Fourth nerve palsy caused by Ehrlichia chaffeensis. 909 62


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