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Volume 29, Number 2—February 2023

Neoehrlichiosis in Symptomatic Immunocompetent Child, South Africa

Colleen Bamford1Comments to Author , Lucille H. Blumberg, Michelle Bosman, John Frean, Kim G.P. Hoek, Janet Miles, Charlotte Sriruttan, Ilse Vorster, and Marinda C. Oosthuizen1
Author affiliations: Pathcare, East London, South Africa (C. Bamford); University of Cape Town, Cape Town, South Africa (C. Bamford); National Institute for Communicable Diseases, Johannesburg, South Africa (L.H. Blumberg, J. Frean, C. Sriruttan); University of Pretoria, Onderstepoort, South Africa (L.H. Blumberg, J. Frean, I. Vorster, M.C. Oosthuizen); University of Stellenbosch, Tygerberg, South Africa (L.H. Blumberg, K.G.P. Hoek); Ampath, East London, South Africa (M. Bosman); University of the Witwatersrand, Johannesburg, South Africa (J. Frean); PathCare Reference Laboratory, Cape Town (K.G.P. Hoek); East London, South Africa (J. Miles)

Main Article


Laboratory and imaging investigations in a case of neoehrlichiosis in a symptomatic immunocompetent child, South Africa

Investigation Patient result Reference value or range
C-reactive protein, mg/L 17.2 <5
Leukocytes, × 109 cells/L 15.8 4.5–13.5
Neutrophils, × 109 cells/L 10.98 1.50–8.5
Lymphocytes, × 109 cells/L 2.99 1.0–6.5
Monocytes, × 109 cells/L 1.50 0–0.8
Platelets, × 109 cells /L 219 140–420
Hemoglobin, g/dL
Blood cultures No growth NA
Urine culture No growth NA
Rickettsia conorii/R. africae serology and PCR on blood Negative NA
SARS-CoV-2 PCR, nasopharyngeal swab and serology Negative NA
Cytomegalovirus PCR and serology Negative NA
Epstein-Barr serology Negative NA
Widal test Negative NA
Mastazyme Brucella ELISA IgM and IgG equivocal NA
Multiplex PCR for atypical and viral respiratory pathogens* Negative NA
QuantiFERON Gold test for tuberculosis†
Ultrasound of the abdomen 15 cm spleen 10–11 cm at this age
Chest radiograph No abnormalities detected NA
Cervical and thoracic spine radiograph No abnormalities detected NA
Transthoracic echocardiography No abnormalities detected NA
Magnetic resonance imaging spine No abnormalities detected NA

*FilmArray RP2.1plus (BioFire Diagnostics, †QuantiFERON,

Main Article

1These authors contributed equally to this article.

Page created: December 22, 2022
Page updated: January 21, 2023
Page reviewed: January 21, 2023
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