pediatric Ehrlichiosis infection - ITP - thrombocytopenia, enlarged spleen

From: JWissmille (jwissmille_at_aol.com)
Date: 09/27/04 

Date: 27 Sep 2004 22:50:21 GMT

J Pediatr Hematol Oncol 2001 Jun-Jul;23(5):324-7 Related Articles, Books,
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Ehrlichiosis infection in a 5-year-old boy with neutropenia, anemia,
thrombocytopenia, and hepatosplenomegaly.

Schiffman J, Haq M, Procopio F, Forman EN.

Division of Pediatric Hematology-Oncology, Hasbro Children's Hospital of Rhode
Island Hospital, Providence 02903, USA.

Ehrlichiosis should be considered in the differential diagnosis of any patient
with recent fever, pancytopenia, hepatosplenomegaly, and history of tick
exposure. We present a previously healthy 5-year-old boy who was referred to
the Hematology-Oncology Clinic to consider a bone marrow etiologic process
after his pediatrician discovered progressive neutropenia, anemia,
thrombocytopenia, and hepatosplenomegaly accompanied by 2 days of fever. Bone
marrow aspirate and biopsy were nonrevealing. Because of the history of a
recent tick bite, a diagnosis of ehrlichiosis infection was considered and
ultimately confirmed by IgG-specific serum testing. The patient's fever was
treated symptomatically with acetaminophen, and symptoms resolved on their own
without intervention. Ehrlichiosis is a tick-borne infection that occurs
throughout the spring and summer, often causing findings that mimic a
malignancy or serious hematologic disorder. The diagnosis should be considered
in any person living in tick-infested areas and can be confirmed by polymerase
chain reaction or serum antibody titers. Treatment with doxycycline can lead to
rapid clinical improvement if the diagnosis is made early.

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PMID: 11464994 [PubMed - indexed for MEDLINE]