Article: Serologic Evidence of Human Monocytic and Granulocytic Ehrlichiosis in Israel.(Statistical Data Included)

To the Editor: We read with great attention the article by Dr. Keysary et al., who reported the first evidence of human monocytic and granulocytic ehrlichiosis in Israel (1); however, we disagree with their conclusions.

Ehrlichiae comprise a large group of intracellular organisms pathogenic for animals and occasionally for humans. Because these organisms are closely related, serologic cross-reactions occur within and between groups, leading to mistakes in identification. For example, Ehrlichia chaffeensis was misdiagnosed as E. canis in humans (2) and human granulocytic ehrlichiosis as human monocytic ehrlichiosis in areas where the vector was not present (3). ...

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