Fig 8. Signs and symptoms of cases of human monocytotropic ehrlichiosis monoinfection reported with individual data (n = 290 cases: 211 immunocompetent, 79 immunocompromized).

A+, diagnosed by PCR, culture and/or immunostaining of biopsy/autopsy/tissue; A, diagnosed by paired IgG IFA serology; B+ diagnosed by microscopy of blood smear or by buffy coat preparation; B, diagnosed by single IgG IFA or ELISA serology; C, diagnosed by IgM serology; D, clinically diagnosed. * definition: altered mental state, confusion, somnolence, delirium, or coma. ^# other neurological symptoms included: ataxia (9.5%); dysarthria (9.5%); agitation (9.5%); hyperreflexia (9.5%); tingling in hand and feet (4.8%); glove and stocking numbness (4.8%); hallucinations (4.8%); hemiparesis (4.8%); hyperosmia (4.8%); tinnitus (4.8%); tremor (4.8%); decreased vision (4.8%); psychotic episodes (4.8%); visual changes + ataxia + tingling + areflexia + decreased vibration sensation with a glove and stocking pattern (4.8%); ataxia + distal sensory loss + global areflexia (4.8%); sixth cranial nerve palsy + diplopia + ataxia (4.8%); bilateral eye deviation + anisocoria (4.8%). † other cardiovascular signs and symptoms included: murmurs (46.7%); additional heart sounds (13.3%); atrial fibrillation (6.7%); hypertension (6.7%); bradycardia (6.7%); muffled heart sounds (6.7%); not further specified irregular heartbeat (6.7%); hypertension + murmur (6.7%). ‡ hemorrhagic manifestations: petechiae (45.5%); ecchymoses (18.1%); epistaxis (9.1%); subconjunctival hemorrhages (9.1%); gingival bleeding (9.1%); ecchymoses + subconjunctival hemorrhages (9.1%). § definition: headache plus neck stiffness and/or photophobia. ^Δ more rare signs and symptoms not included in the figure: <1–2%: dizziness, chest pain, otalgia, syncope, vertigo, epididymitis/epididymal pain, unspecified falls.