Cerebral haemorrhage as a clinical manifestation of human ehrlichiosis

Abstract

A 16-year-old young man presented to the emergency room with new-onset generalised tonic-clonic seizures. Examination showed a Glasgow score of 13 and predominantly crural left hemiparesis. Imaging demonstrated a right frontoparietal haemorrhage of non-vascular origin with perilesional oedema. Surgical drainage was carried out, but rebleeding occurred within 24 hours following surgery, and again 1 week after discharge. On reinterrogation and examination, infection was suspected and empirical management with doxycycline was begun. Improvement was evident 72 hours after antibiotic initiation, and PCR confirmed the diagnosis; thus, doxycycline was continued for 6 months. After 2 years, seizures recurred and treatment was reinstated with good clinical response. However, seizures reappeared whenever treatment discontinuation was attempted. Lacking alternatives, doxycycline was maintained up to the third year following the initial episode. Subsequently, the patient showed complete resolution without neurological sequelae up to his last follow-up visit, 12 months following treatment cessation.

Annexin A2 depletion exacerbates the intracerebral microhemorrhage induced by acute rickettsia and Ebola virus infections

“…However, the role of CMHs complicating infections [55][56][57][58], in particular, acute infections, has been poorly explored [34,[59][60][61]. To the best of our knowledge, four clinic reports from PLOS NEGLECTED TROPICAL DISEASES different countries described a total of 11 cases of CMH after acute systemic infections in patients ranging in age from 9 to 71 years [62][63][64][65]. Nine cases in two reports correlated the CMHs with specific pathogen infections, spotted fever (SF) rickettsiosis or ehrlichiosis [65].…”

“…To the best of our knowledge, four clinic reports from different countries described a total of 11 cases of CMH after acute systemic infections in patients ranging in age from 9 to 71 years[ 62 – 65 ]. Nine cases in two reports correlated the CMHs with specific pathogen infections, spotted fever (SF) rickettsiosis or ehrlichiosis[ 65 ]. Taken together, this information suggests there are potentially more undiscovered cases of CMHs accompanying acute systemic infections.…”

Development of a Loop-Mediated Isothermal Amplification (LAMP) Assay Targeting the Citrate Synthase Gene for Detection of Ehrlichia canis in Dogs

“…Our recent study suggested that CME is the leading TBD of dogs in the Philippines [ 7 ]. Aside from causing significant morbidities and fatalities in dogs, E. canis is recognized as a potential zoonotic pathogen after being reported in some cases in humans [ 22 , 23 , 24 ]. Early diagnosis is crucial to control the progress of infection promptly.…”

Annexin A2 depletion exacerbates the intracerebral microhemorrhage induced by acute rickettsia and Ebola virus infections

“…Nine cases in two reports correlated the CMHs with specific pathogen infections, spotted fever (SF) rickettsiosis or ehrlichiosis [37]. Taken together, this information suggests there are potentially more undiscovered cases of CMHs accompanying acute systemic infections.…”

“…To the best of our knowledge, four clinic reports from different countries described a total of 11 cases of CMH after acute systemic infections in patients ranging in age from 9 to 71 years [34][35][36][37].…”