Ehrlichiosis infection mimicking thrombotic microangiopathy syndrome early after kidney transplantation

Waleed Hassan, Manish Talwar, Vasanthi Balaraman, Miklos Z. Molnar

Research output: Contribution to journalArticle


Fever of unknown origin and the clinical picture of thrombotic microangiopathy (TMA) are diagnostic challenges in the early period after kidney transplantation. Here, we report a case of human monocytic ehrlichiosis in a renal allograft recipient who presented with fever and clinical picture of TMA in the first month post–kidney transplant. Despite broad coverage with multiple antimicrobial agents, fever and hematological abnormalities persisted for several days. A history of contact exposure and living in an endemic area raised clinical suspicion for human monocytic ehrlichiosis (HME), and empiric treatment with doxycycline was initiated. Definitive diagnosis of HME was confirmed by polymerase chain reaction (PCR) for Ehrlichia chaffeensis. Human ehrlichiosis should be considered within the differential diagnosis in kidney transplant recipients with the clinical picture of TMA and fever of unknown origin. Furthermore, early treatment with doxycycline enhances rapid resolution of clinical and laboratory recovery.

Original languageEnglish
JournalTransplant Infectious Disease
Publication statusAccepted/In press - Jan 1 2020


  • ehrlichiosis
  • kidney transplant

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

Fingerprint Dive into the research topics of 'Ehrlichiosis infection mimicking thrombotic microangiopathy syndrome early after kidney transplantation'. Together they form a unique fingerprint.

  • Cite this