Renal, Hepatic, and Marrow Dysfunction in a Patient with Chronic Renal Insufficiency

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2003 Mar 20

PMID 12644928

Authors

Rebecca C Brady

John J Bissler

Affiliations

Soon will be listed here.

Abstract

Severe illness with acute renal failure, leukopenia, thrombocytopenia, and coagulopathy frequently occurs with hemolytic uremic syndrome/thrombotic thrombocytopenic purpura, hematological malignancies, sepsis, and collagen-vascular diseases. We present a 16-year-old male fast-food worker with underlying chronic renal insufficiency who manifested these abnormalities as a result of Ehrlichia chaffeensis sepsis. Doxycycline therapy and aggressive supportive care led to complete recovery.

References

Buller R, Arens M, Hmiel S, Paddock C, Sumner J, Rikhisa Y . Ehrlichia ewingii, a newly recognized agent of human ehrlichiosis. N Engl J Med. 1999; 341(3):148-55. DOI: 10.1056/NEJM199907153410303. View

Fritz C, Glaser C . Ehrlichiosis. Infect Dis Clin North Am. 1998; 12(1):123-36. DOI: 10.1016/s0891-5520(05)70413-x. View

Codner E, Maslin W . Investigation of renal protein loss in dogs with acute experimentally induced Ehrlichia canis infection. Am J Vet Res. 1992; 53(3):294-9. View

Peters T, Edwards K, Standaert S . Severe ehrlichiosis in an adolescent taking trimethoprim-sulfamethoxazole. Pediatr Infect Dis J. 2000; 19(2):170-2. DOI: 10.1097/00006454-200002000-00021. View

Marty A, Dumler J, Imes G, Brusman H, Smrkovski L, Frisman D . Ehrlichiosis mimicking thrombotic thrombocytopenic purpura. Case report and pathological correlation. Hum Pathol. 1995; 26(8):920-5. DOI: 10.1016/0046-8177(95)90017-9. View

Codner E, Caceci T, Saunders G, Smith C, Robertson J, Martin R . Investigation of glomerular lesions in dogs with acute experimentally induced Ehrlichia canis infection. Am J Vet Res. 1992; 53(12):2286-91. View

Walker D, Barbour A, Oliver J, Lane R, Dumler J, Dennis D . Emerging bacterial zoonotic and vector-borne diseases. Ecological and epidemiological factors. JAMA. 1996; 275(6):463-9. View

Ratnasamy N, EVERETT E, Roland W, McDonald G, CALDWELL C . Central nervous system manifestations of human ehrlichiosis. Clin Infect Dis. 1996; 23(2):314-9. DOI: 10.1093/clinids/23.2.314. View

Patel R, Byrd M . Near fatal acute respiratory distress syndrome in a patient with human ehrlichiosis. South Med J. 1999; 92(3):333-5. DOI: 10.1097/00007611-199903000-00017. View

10.

Fishbein D, DAWSON J, Robinson L . Human ehrlichiosis in the United States, 1985 to 1990. Ann Intern Med. 1994; 120(9):736-43. DOI: 10.7326/0003-4819-120-9-199405010-00003. View

11.

Dumler J, Bakken J . Ehrlichial diseases of humans: emerging tick-borne infections. Clin Infect Dis. 1995; 20(5):1102-10. DOI: 10.1093/clinids/20.5.1102. View

12.

Dumler J, Barbet A, Bekker C, Dasch G, Palmer G, Ray S . Reorganization of genera in the families Rickettsiaceae and Anaplasmataceae in the order Rickettsiales: unification of some species of Ehrlichia with Anaplasma, Cowdria with Ehrlichia and Ehrlichia with Neorickettsia, descriptions of six new species.... Int J Syst Evol Microbiol. 2002; 51(Pt 6):2145-2165. DOI: 10.1099/00207713-51-6-2145. View

13.

Bakken J, Dumler J, Chen S, Eckman M, Van Etta L, Walker D . Human granulocytic ehrlichiosis in the upper Midwest United States. A new species emerging?. JAMA. 1994; 272(3):212-8. View

14.

Edwards M . Human ehrlichiosis. Adv Pediatr Infect Dis. 1991; 6:163-78. View

15.

Scaglia F, Vogler L, Hymes L, Maki Jr A . Minimal change nephrotic syndrome: a possible complication of ehrlichiosis. Pediatr Nephrol. 1999; 13(7):600-1. DOI: 10.1007/s004670050666. View

16.

Fuchs M, Scheid C, Schulz A, Diehl V, Sohngen D . Trimethoprim/sulfamethoxazole prophylaxis impairs function of mobilised autologous peripheral blood stem cells. Bone Marrow Transplant. 2000; 26(7):815-6. DOI: 10.1038/sj.bmt.1702586. View

17.

Jacobs R, Schutze G . Ehrlichiosis in children. J Pediatr. 1997; 131(2):184-92. DOI: 10.1016/s0022-3476(97)70152-5. View

18.

Paddock C, Folk S, Shore G, Machado L, Huycke M, Slater L . Infections with Ehrlichia chaffeensis and Ehrlichia ewingii in persons coinfected with human immunodeficiency virus. Clin Infect Dis. 2001; 33(9):1586-94. DOI: 10.1086/323981. View

19.

McQuiston J, Paddock C, Holman R, Childs J . The human ehrlichioses in the United States. Emerg Infect Dis. 1999; 5(5):635-42. PMC: 2627718. DOI: 10.3201/eid0505.990504. View

20.

Shea K, Calio A, Klein N, Cunha B . Rhabdomyolysis associated with Ehrlichia chaffeensis infection. Clin Infect Dis. 1995; 21(4):1056-7. DOI: 10.1093/clinids/21.4.1056. View