Challenges of Diagnosing Severe Ehrlichiosis in Orthotopic Liver Transplant Recipients

Table 1

All cases of ehrlichiosis complicating solid organ transplants.

Total cases	Age median; (Yr, range)	Sex	Transplant type	Diagnosis method	Management	Outcome	References
25	54 (26-68)	68% M	H (2), Li (5), Lu (5), R (13)	PCR	Dox	S	Lawrence et al. [10]
51	57 (9-72)	75% M	H (12), Li (7), Lu (12), R (18), R/P (2)	PCR	NA	S	Otrock et al. [11]
1	69	F	Lu	PCR, PBS	Dox	S	Regunath et al. [18]
15	50 (15-73)	87% M	H (6), Li (1), Lu (1), R (7)	PCR (93%), Ser (7%)	Dox	S	Thomas et al.[9]
2	56, 57	50% M	R (2)	PCR (50%), Ser (50%)	Dox, Tigecycline	S	Sachdev et al. [25]
1	38	M	Lu	PCR, PBS	Dox	S	Safdar et al. [23]
1	57	M	Li	PCR, Ser	Dox	S	Liddell et al. [24]
1	63	M	R	PCR, PBS	Dox	S	Kumar et al. [26]
1	60	M	R	PCR, PBS, Ser	Dox	S	Cotant et al. [27]
1	11	M	R	PCR	Dox	S	Buller et al. [28]
1	NA	M	R	PCR	Dox	S	Sadikot et al. [29]
1	35	M	R	Ser, PCR	Dox	S	Schutze et al. [30]
1	47	M	Li	PCR	Dox	S	Tan et al. [14]
1	27	M	R	PBS, Ser	Dox	S	Dorn et al. [31]
1	35	F	R	PCR	Dox	S	Masterson et al. [7]
27	NA	NA	NA	PCR	Dox	NA	Kuriakose et al. [8]
1	51	M	Li	Ser	Dox	S	Antony et al. [32]
3	38, 41, 50	66% M	P/R, P/R, P	PBS	Dox	66% S	Trofe et al. [33]
1	67	M	R	PBS, PCR	Dox	S	Adachi et al. [34]
1	66	F	R	PBS, PCR	Dox	S	Vannorsdall et al. [35]
1	57	M	R	PCR	Dox	S	Hassan et al. [36]
5	43 (5-70)	M	Lu (1), R (4)	PCR (80%); PBS (20%)	Dox	60% S	Saha et al. [15]

D: death; Dox: doxycycline; F: female; H: heart; Li: liver; Lu: lung; M: male; NA: not available; P: pancreas; PBS: peripheral blood smear; PCR: polymerase chain reaction; R: renal; Ser: serology; S: survived; Yr: year. This table helps demonstrate that, while HME can occur in a wide range of ages, it is most often seen in older patients. Interestingly, PCR was most often used to help diagnose HME. Notably, most patients received doxycycline and had a good outcome.