Table 16. Reported fatal cases of human monocytotropic ehrlichiosis (n = 34).
| No. | Year of publication | Age of patient(years) | Sex of patient | Country of infection | Pre-existing medical conditions | Immunosuppressive therapy | Time between first symptoms and medical presentation (days) | Level of diagnostic certainty # | Antimicrobial treatment | Time between presentation to hospital and specific therapy (days) | Complications/cause of death | Time from first symptoms to death | Ref. |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 1990 | 68 | M | USA | Hypertension | N.r. | N.r. | A | Doxy., chloramphenicol | N.r. | AKI | 68 | [86] |
| 2 | 1991 | 67 | M | USA | N.r | N.r. | N.r. | B | Chloramphenicol | N.r. | Multi organ failure | N.r. | [87] |
| 3 | 1993 | 68 | M | USA | Lobectomy | N.r. | 7 | B | Doxy., chloramphenicol | 7 | Multi organ failure | 68 | [88] |
| 4 | 1993 | 41 | F | USA | HIV+, intestinal strongyloidiasis | N.r. | N.r. | A+ | N.r. | N.r. | Respiratory failure, pulmonary hemorrhage | 16 | [89] |
| 5 | 1996 | 36 | M | USA | HIV+ | N.r. | N.r. | A | N.r. | N.r. | AKI | N.r. | [90] |
| 6 | 1996 | 73 | M | USA | N.r. | N.r. | N.r. | B | Doxy. | N.r. | AKI | N.r. | [91] |
| 7 | 1997 | 13 | F | USA | N.r. | N.r. | 7 | B | N.r. | N.r. | Encephalopathy, multi-organ failure | 9 | [92] |
| 8 | 1997 | 51 | F | USA | Hashimoto’s thyreoiditis | N.r. | 7 | A | Doxy. | 5 | Encephalopathy, multi-organ failure | 13 | [93] |
| 9 | 1999 | 22 | M | USA | N.r. | N.r. | 7 | A+ | Doxy. | 0 | Seizures, multi organ failure | 10 | [94] |
| 10 | 1999 | 38 | M | USA | AIDS, Hepatitis B, Hepatitis C | N.r. | N.r. | A+ | Unspecified appropriate agent | N.r. | Seizures, multiple-organ failure | N.r. | [94] |
| 11 | 2001 | 52 | M | USA | HIV+ | N.r. | N.r. | A+ | N.r. | N.r. | AKI, pneumonia | 10 | [95] |
| 12 | 2001 | 66 | M | USA | N.r. | N.r. | 10 | A+ | N.r. | N.r. | Seizures, multi organ failure | 18 | [95] |
| 13 | 2001 | 80 | F | USA | MGUS | N.r. | 6 | A+ | Doxy. | N.r. | Respiratory failure | 7 | [95] |
| 14 | 2001 | 20 | M | Brazil | N.r. | N.r. | N.r. | B | N.r. | N.r. | Respiratory insufficiency, AKI | 10 | [95] |
| 15 | 2004 | 19 | F | USA | N.r. | N.r. | 7 | B | Doxy. | N.r. | Multi organ failure | N.r. | [96] |
| 16 | 2006 | 52 | M | USA | HIV+ | N.r. | 4 | A+ | Doxy. | N.r. | Pneumonia, AKI | 10 | [42] |
| 17 | 2006 | 15 | M | Brazil | N.r. | Yes | N.r. | A | Chloramphenicol | N.r. | Encephalitis | N.r. | [97] |
| 18 | 2009 | 40 | M | USA | N.r. | N.r. | 14 | A+ | N.r. | N.r. | Encephalopathy, multi-organ failure | N.r. | [98] |
| 19 | 2010 | 7 | M | USA | ALL | Yes | 1 | A+ | Doxy. | N.r. | Respiratory failure, seizure, cardiac arrest | 9 | [99] |
| 20 | 2011 | 60 | F | USA | Melanoma | N.r. | 14 | A+ | N.r. | N.r. | Coagulopathy, multi organ failure | 16 | [100] |
| 21 | 2012 | 7 | M | USA | ALL | Yes | 4 | A+ | Doxy. | N.r. | Septic shock, Multi organ failure, | 10 | [101] |
| 22 | 2014 | 56 | F | USA | N.r. | N.r. | N.r. | A+ | Doxy. | N.r. | Seizure, myocardial infarction, multi-organ failure | N.r. | [102] |
| 23 | 2014 | 45 | M | USA | N.r. | N.r. | N.r. | A+ | N.r. | N.r. | Myocardial infarction, status epilepticus, meningitis, multi organ failure | N.r. | [102] |
| 24 | 2016 | 31 | F | Mexico | N.r. | N.r. | 15 | A+ | Doxy. | N.r. | Encephalopathy, multi organ failure | 27 | [103] |
| 25 | 2017 | 66 | F | USA | HIV+ | N.r. | N.r. | A+ | N.r. | N.r. | Septic shock, HLH | N.r. | [59] |
| 26 | 2017 | 45 | M | USA | N.r. | N.r. | 7 | A+ | Doxy. | N.r. | Abdominal compartment syndrome, multi-organ failure | 14 | [104] |
| 27 | 2018 | 26 | M | USA | DM | N.r. | N.r. | A+ | Doxy. | N.r. | HLH, DIC, sepsis, cerebral edema, focal hemorrhages and herniation | N.r. | [60] |
| 28 | 2020 | 37 | M | Mexico | Femoral fracture | N.r. | N.r. | A+ | N.r. | N.r. | Septic shock | N.r. | [16] |
| 29 | 2020 | 95 | F | USA | Dementia | N.r. | N.r. | A+ | Doxy. | N.r. | Encephalopathy | N.r. | [105] |
| 30 | 2020 | 7 | F | USA | N.r. | N.r. | 7 | A+ | Doxy. | N.r. | HLH, multi organ failure | N.r. | [69] |
| 31 | 2021 | 66 | M | USA | Adult Still disease | Yes | 7 | A+ | N.r. | N.r. | HLH, respiratory failure, meningoencephalitis | 28 | [72] |
| 32 | 2021 | 72 | M | USA | Multiple myeloma, ASCT | Yes | N.r. | A+ | Doxy. | 4 | HLH, multi-organ failure | N.r. | [73] |
| 33 | 2021 | 70 | M | USA | Kidney transplant | Yes | N.r. | A+ | Doxy. | N.r. | HLH, seizure, sepsis | 34 | |
| 34 | 2021 | 66 | M | USA | Kidney transplant, Adult Still disease | Yes | 1 | A+ | N.r. | N.r. | HLH, cardiac arrest | 12 | [17] |
AIDS, acquired immune deficiency syndrome; AKI, acute kidney injury/kidney failure; ARDS, acute respiratory distress syndrome; ASCT, autologous stem cell transplantation; DIC; disseminated intravascular coagulopathy; DM, diabetes mellitus; Doxy, Doxycycline; ESRD, end-stage renal disease; HIV+, human immunodeficiency virus positive; HLH, hemophagocytic lymphohistiocytosis; IgG, immunoglobulin G;MGUS, monoclonal gammopathy of undetermined significance; N.r.; None/not reported; UTI, urinary tract infection; USA, United States of America.
# A, diagnosed by paired IgG IFA serology; A+, diagnosed by PCR, immunostaining of biopsy/autopsy tissue and/or culture; B, diagnosed by IgG single titre IFA serology.