Case report

The first report of human illness associated with the Panola Mountain Ehrlichia species: a case report

Will K Reeves^1,3 , Amanda D Loftis^2,3 , William L Nicholson³ and Alan G Czarkowski³

¹  USDA-ARS-ABADRL, Department 3354, 1000 E University Ave, Laramie, WY 82071-2000, USA

²  226 North Lincoln St, Laramie, WY 82070, USA

³  Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS G-13, Atlanta, GA 30333, USA

author email corresponding author email

Journal of Medical Case Reports 2008, 2:139doi:10.1186/1752-1947-2-139

Published:	30 April 2008

Abstract

Introduction

Two species of Ehrlichia are known to cause human illness. Several other species have been discovered in ticks and animals, and recent reports suggest that some of these Ehrlichia species might be human pathogens. We report here the first association of a recently discovered pathogen, the Panola Mountain Ehrlichia species, with a case of human illness.

Case presentation

A 31-year-old man from Atlanta, Georgia (GA) in the United States of America (USA) presented with a persistent sore neck of 3 weeks duration following a tick bite. DNA from the Panola Mountain Ehrlichia species, which was recently discovered in a goat in Georgia, was detected in an acute blood sample. Serologic testing was inconclusive. Polymerase chain reaction tests for other tick-borne diseases found in this region were negative. The patient rapidly improved in response to doxycycline therapy.

Conclusion

Detection of Ehrlichia DNA in an acute blood sample meets the Centers for Disease Control and Prevention laboratory confirmation criteria for ehrlichiosis, and response to doxycycline provides supporting clinical evidence. The Panola Mountain Ehrlichia species, an emerging pathogen transmitted by ticks in the eastern USA, should be considered as a possible cause of tick-borne illness in this region.