{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:42:00Z","timestamp":1789926120442,"version":"4.0.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012377","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000}}],"reference-count":140,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Human monocytotropic ehrlichiosis (HME) is a tick-borne bacterial infection caused by <jats:italic>Ehrlichia chaffeensis<\/jats:italic>. Most available data come from case reports, case series and retrospective studies, while prospective studies and clinical trials are largely lacking. To obtain a clearer picture of the currently known epidemiologic distribution, clinical and paraclinical presentation, diagnostic aspects, complications, therapeutic aspects, and outcomes of HME, we systematically reviewed the literature and analyzed and summarized the data. Cases of HME are almost exclusively reported from North America. Human infections due to other (non-<jats:italic>chaffeensis<\/jats:italic>) <jats:italic>Ehrlichia<\/jats:italic> spp. are rare. HME primarily presents as an unspecific febrile illness (95% of the cases), often accompanied by thrombocytopenia (79.1% of the cases), leukopenia (57.8% of the cases), and abnormal liver function tests (68.1% of the cases). Immunocompromized patients are overrepresented among reviewed HME cases (26.7%), which indicates the role of HME as an opportunistic infection. The incidence of complications is higher in immunocompromized compared to immunocompetent cases, with ARDS (34% vs 19.8%), acute renal failure (34% vs 15.8%), multi organ failure (26% vs 14.9%), and secondary hemophagocytic lymphohistiocytosis (26% vs 14.9%) being the most frequent reported. The overall case fatality is 11.6%, with a significant difference between immunocompetent (9.9%) and immunocompromized (16.3%) cases, and sequelae are rare (4.2% in immunocompetent cases, 2.5% in immunocompromised cases).<\/jats:p>","DOI":"10.1371\/journal.pntd.0012377","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T17:29:52Z","timestamp":1722619792000},"page":"e0012377","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":27,"title":["Human monocytotropic ehrlichiosis\u2014A systematic review and analysis of the literature"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3663-2722","authenticated-orcid":true,"given":"Larissa","family":"Gygax","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Schudel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4026-9760","authenticated-orcid":true,"given":"Christian","family":"Kositz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Kuenzli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Neumayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"issue":"6","key":"pntd.0012377.ref001","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1099\/00207713-51-6-2145","article-title":"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 combinations and designation of Ehrlichia equi and \u2019HGE agent\u2019 as subjective synonyms of Ehrlichia phagocytophila","volume":"51","author":"JS Dumler","year":"2001","journal-title":"International Journal of Systematic and Evolutionary Microbiology"},{"issue":"2","key":"pntd.0012377.ref002","first-page":"9","article-title":"Studies on the causative agent of \u201cHyuganetsu\u201d disease. 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