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Journal of Clinical Microbiology, February 2000, p. 635-638, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Serology of Culture-Confirmed Cases of Human Granulocytic Ehrlichiosis

Maria E. Aguero-Rosenfeld,1,* Fatemeh Kalantarpour,2 Mehdi Baluch,1 Harold W. Horowitz,2 Donna F. McKenna,2 John T. Raffalli,2 Tze-chen Hsieh,3 Joseph Wu,3 J. Stephen Dumler,4 and Gary P. Wormser2

Department of Pathology,1 Department of Medicine, Division of Infectious Diseases,2 and Department of Biochemistry and Molecular Biology,3 New York Medical College, Westchester Medical Center, Valhalla, New York, and Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland4

Received 16 August 1999/Returned for modification 8 October 1999/Accepted 23 November 1999

We evaluated the antibody responses in the sera of 24 patients with culture-confirmed human granulocytic ehrlichiosis (HGE). Antibody titers were measured by an indirect immunofluorescent-antibody assay (IFA) by using a local human isolate as the source of antigen. All patients received appropriate antimicrobial treatment. One hundred five serum specimens collected at baseline and at periodic intervals for up to 14 months were included in the study. Seroconversion was observed in 21 of 23 patients (91.3%) from whom convalescent-phase sera were obtained. Antibodies were first detected at an average of 11.5 days after onset of symptoms. Peak titers (>= 2,560 for 71.4% of patients and >= 640 for 95.2% of patients) were obtained an average of 14.7 days after onset of symptoms. Eleven of 13 patients (84.6%) from whom sera were collected between 6 and 10 months after onset of symptoms were still seropositive, and sera from 5 of 10 (50%) patients tested positive between 11 and 14 months after onset of symptoms. For a subset of 71 serum specimens from 17 patients with culture-confirmed HGE also tested by IFA by using either a human isolate from Wisconsin or an Ehrlichia equi isolate from a horse, there was qualitative agreement for 62 serum specimens (87.3%). Peak titers were higher, however, with the local human HGE isolate, but the difference was not statistically significant. In summary, most patients with culture-confirmed HGE develop antibodies within 2 weeks of onset of symptoms. Antibodies reach high titers during the first month and remain detectable in about one-half of patients at 1 year after onset of symptoms.

* Corresponding author. Mailing address: Clinical Laboratories Room 1J-11a, Westchester Medical Center, Valhalla, NY 10505. Phone: (914) 493-7389. Fax: (914) 493-5742. E-mail: maria_aguero-rosenfeld{at}nymc.edu.

Journal of Clinical Microbiology, February 2000, p. 635-638, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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