Fever, pancytopenia, and elevated D-dimer in a 95-year-old woman with ehrlichiosis: a case report.
BMC Geriatr
; 21(1): 178, 2021 03 12.
Article
in English
| MEDLINE | ID: covidwho-1133582
ABSTRACT
BACKGROUND:
Pancytopenia, fever, and elevated D-dimer are significant clinical findings. The differential diagnosis includes hematological malignancies, severe coronavirus disease 2019 (COVID-19), tick-borne illnesses, and other etiologies. CASE PRESENTATION We report the case of a 95-year-old woman who presented with high fever (103.6 °F), pancytopenia, and markedly elevated D-dimer (32.21 mg/L; reference range ≤ 0.95 mg/L) in late-autumn during the COVID-19 pandemic at a large academic institution. After remaining persistently febrile, a peripheral blood smear was ordered and revealed parasites consistent with Ehrlichia spp. Doxycycline monotherapy led to symptomatic improvement and resolution of her pancytopenia. During her hospital stay, a computed tomography angiogram of the chest revealed pulmonary emboli, and esophagogastroduodenoscopy uncovered arteriovenous malformations. After appropriate treatment, she was discharged on hospital day 7 and has since done well.CONCLUSIONS:
Overall, our case offers a dramatic, unexpected presentation of ehrlichiosis in a nonagenarian. To our knowledge, this is the first report of concurrent ehrlichiosis and pulmonary embolus.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pancytopenia
/
Ehrlichiosis
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Etiology study
/
Prognostic study
Topics:
Long Covid
Limits:
Female
/
Humans
Language:
English
Journal:
BMC Geriatr
Journal subject:
Geriatrics
Year:
2021
Document Type:
Article
Affiliation country:
S12877-021-02129-6
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