Evidence map›Paper›PMID 33711942›Full record

ArticleBMC geriatrics2021

Fever, pancytopenia, and elevated D-dimer in a 95-year-old woman with ehrlichiosis: a case report.

Christopher Radcliffe, Cynthia Tsay, Kimberly Glerum, Jane Liao, George Goshua, Gerard Kerins

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 54% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Christopher RadcliffeYale University School of Medicine, 333 Cedar St., CT, 06510, New Haven, USA. christophervradcliffe@gmail.com.ORCID 0000-0001-8352-1482
Cynthia TsayDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Kimberly GlerumDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Jane LiaoDepartment of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
George GoshuaSection of Hematology and Oncology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Gerard KerinsYale University School of Medicine, 333 Cedar St., CT, 06510, New Haven, USA.
Yale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

backgroundPancytopenia, 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.

conclusionsOverall, 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.

Indexed as

COVID-19EhrlichiosisPancytopeniaAged, 80 and overFemaleFibrin Fibrinogen Degradation ProductsHumansPandemicsSARS-CoV-2Fibrin Fibrinogen Degradation Productsfibrin fragment DCase reportEhrlichiosisPancytopeniaPulmonary embolus

Identifiers

PMID33711942
PMCPMC7953191
OpenAlexW3110812020

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.