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Cited by 422

The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.

Ehrlichia ewingii,a Newly Recognized Agent of Human Ehrlichiosis

Open access
Buller, Richard S., Arens, Max, Hmiel, S. Paul, Paddock, Christopher D., Sumner, John W., Rikihisa, Yasuko, Unver, Ahmet, Gaudreault-Keener, Monique, Manian, Farrin A., Liddell, Allison M., Schmulewitz, Nathan, Storch, Gregory A.·1999·New England Journal of Medicine
DOI 10.1056/nejm199907153410303
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Abstract

BACKGROUND: Human ehrlichiosis is a recently recognized tick-borne infection. Four species infect humans: Ehrlichia chaffeensis, E. sennetsu, E. canis, and the agent of human granulocytic ehrlichiosis. METHODS: We tested peripheral-blood leukocytes from 413 patients with possible ehrlichiosis by broad-range and species-specific polymerase-chain-reaction (PCR) assays for ehrlichia. The species present were identified by species-specific PCR assays and nucleotide sequencing of the gene encoding ehrlichia 16S ribosomal RNA. Western blot analysis was used to study serologic responses. RESULTS: In four patients, ehrlichia DNA was detected in leukocytes by a broad-range PCR assay, but not by assays specific for E. chaffeensis or the agent of human granulocytic ehrlichiosis. The nucleotide sequences of these PCR products matched that of E. ewingii, an agent previously reported as a cause of granulocytic ehrlichiosis in dogs. These four patients, all from Missouri, presented between May and August 1996, 1997, or 1998 with fever, headache, and thrombocytopenia, with or without leukopenia. All had been exposed to ticks, and three were receiving immunosuppressive therapy. Serum samples obtained from three of these patients during convalescence contained antibodies that reacted with E. chaffeensis and E. canis antigens in a pattern different from that of humans with E. chaffeensis infection but similar to that of a dog experimentally infected with E. ewingii. Morulae were identified in neutrophils from two patients. All four patients were successfully treated with doxycycline. CONCLUSIONS: These findings provide evidence of E. ewingii infection in humans. The associated disease may be clinically indistinguishable from infection caused by E. chaffeensis or the agent of human granulocytic ehrlichiosis.

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Metadata

Authors
Buller, R. S., Arens, M., Hmiel, S. P., Paddock, C. D., Sumner, J. W., Rikihisa, Y., Unver, A., Gaudreault-Keener, M., Manian, F. A., Liddell, A. M., Schmulewitz, N., & Storch, G. A.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1999-07-15
Volume
341
Issue
3
Pages
148-155
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199907153410303
OpenAlex
W2076911266
Cited by
422
References
17
FWCI
18.39
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Ehrlichia ewingii,a Newly Recognized Agent of Human Ehrlichiosis. https://app.cochat.ai/papers/10.1056/nejm199907153410303
The paper
Buller, R. S., Arens, M., Hmiel, S. P., Paddock, C. D., Sumner, J. W., Rikihisa, Y., Unver, A., Gaudreault-Keener, M., Manian, F. A., Liddell, A. M., Schmulewitz, N., & Storch, G. A. (1999). Ehrlichia ewingii,a Newly Recognized Agent of Human Ehrlichiosis. New England Journal of Medicine. https://doi.org/10.1056/nejm199907153410303

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.