ArticleJournal of clinical microbiology1999
Inter- and intralaboratory comparison of Ehrlichia equi and human granulocytic ehrlichiosis (HGE) agent strains for serodiagnosis of HGE by the immunofluorescent-antibody test.
Article in Journal of clinical microbiology, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 77 citations in OpenAlex.
- Utility of combined detection of IgG/IgM/IgA vs. separate IgG and IgM antibodies to Anaplasma phagocytophilum in culture and PCR-confirmed patients with human granulocytic anaplasmosis.Wiener klinische Wochenschrift · 2026Article
- Human Granulocytic Anaplasmosis as a COVID-19 Mimicker.European journal of case reports in internal medicine · 2021Article
- Epidemiology, Clinical Aspects, Laboratory Diagnosis and Treatment of Rickettsial Diseases in the Mediterranean Area During COVID-19 Pandemic: A Review of the Literature.Mediterranean journal of hematology and infectious diseases · 2020Review
- Use of Peptide-Based Enzyme-Linked Immunosorbent Assay followed by Immunofluorescence Assay To Document Ehrlichia chaffeensis as a Cause of Febrile Illness in Nicaragua.Journal of clinical microbiology · 2016Article
- Associated Factors to Seroprevalence ofJournal of tropical medicine · 2016Article
- Human granulocytic anaplasmosis.Infectious disease clinics of North America · 2015Review
- First reported case of Ehrlichia ewingii involving human bone marrow.Journal of clinical microbiology · 2014Article
- Canine infection with Dirofilaria immitis, Borrelia burgdorferi, Anaplasma spp., and Ehrlichia spp. in the United States, 2010-2012.Parasites & vectors · 2014Article
- Anaplasma phagocytophilum antibodies in humans, Japan, 2010-2011.Emerging infectious diseases · 2014Article
- Comparison of a real-time PCR method with serology and blood smear analysis for diagnosis of human anaplasmosis: importance of infection time course for optimal test utilization.Journal of clinical microbiology · 2013Article
- Prevalence of Anaplasma phagocytophilum infection and effect on lamb growth.Acta veterinaria Scandinavica · 2011Article
- Current management of human granulocytic anaplasmosis, human monocytic ehrlichiosis and Ehrlichia ewingii ehrlichiosis.Expert review of anti-infective therapy · 2009Review
- Detection of antibodies to Anaplasma phagocytophilum and Ehrlichia chaffeensis antigens in sera of Korean patients by western immunoblotting and indirect immunofluorescence assays.Clinical and diagnostic laboratory immunology · 2003Article
- Serological evidence for human granulocytic ehrlichiosis in Western Austria.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2003Article
- Expression of multiple outer membrane protein sequence variants from a single genomic locus of Anaplasma phagocytophilum.Infection and immunity · 2003Article
- Serologic and molecular detection of Ehrlichia chaffeensis and Anaplasma phagocytophila (human granulocytic ehrlichiosis agent) in Korean patients.Journal of clinical microbiology · 2002Article
- Diagnosis of granulocytic ehrlichiosis in humans by immunofluorescence assay.Clinical and diagnostic laboratory immunology · 2001Article
- Serological investigation of granulocytic Ehrlichia infection in sheep in Norway.Acta veterinaria Scandinavica · 2001Article
- Persistence of Ehrlichia phagocytophila infection in two age groups of lambs.Acta veterinaria Scandinavica · 2001Article
- Persistence of granulocytic Ehrlichia infection during wintertime in two sheep flocks in Norway.Acta veterinaria Scandinavica · 2001Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
Human granulocytic ehrlichiosis (HGE) is usually diagnosed by immunofluorescent antibody (IFA) serology with Ehrlichia equi-infected neutrophils or HGE agent-infected cultured HL60 cells. The HGE agent and E. equi are antigenically diverse, and interpretation of serologic results is also often variable. Thus, we investigated the sensitivity and specificity of various HGE agent and E. equi antigens used for IFA diagnosis by three different laboratories. Serum samples from 28 patients with well-characterized HGE and 9 patients with suspected HGE who were investigated by PCR, blood smear examinations, and serology were used, along with 9 serum samples from patients with other rickettsial and ehrlichial infections. Each serum sample was tested with up to 10 different antigen preparations. Overall, qualitative IFA results agreed in 70% of the samples. Titers among antigens were similar (r = 0.89 to 0. 96), but titers of individual samples varied by fourfold or more in 5 of 81 (6%) of the serum samples. Sensitivity ranged from 100% to 82%, and specificity varied from 100% to 67%, but these differences were not significant, even among those tested in the same laboratory or between two different laboratories. Antibodies were detected in 14 to 44% of acute-phase sera from confirmed HGE patients. Most false-positive reactions resulted with Ehrlichia chaffeensis; when these sera were excluded, the specificity of most antigens was 91 to 100%. These data indicate that IFA results often agree and that IFA is useful for diagnosis of HGE in convalescence. However, without further standardization, variability among serologic tests using E. equi and HGE agent isolates for diagnosis of HGE will occasionally provide discrepant results and confound diagnosis.
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