Transmission of Human Granulocytic Ehrlichiosis

To the Editor. —The recent discovery of human granulocytic ehrlichiosis (HGE) in Wisconsin and Minnesota¹,²is highly significant because it alerts physicians to the presence of a potentially fatal but generally treatable disease. Our recent experiences support the described clinical presentations of the disease, and the following case report provides preliminary evidence thatIxodes scapularisis a vector of HGE. In the fall of 1993, a 57-year-old man who resided in central Wisconsin presented to his personal physician with a temperature of 40°C, severe chills, and myalgias. The patient had recently returned from a visit to northwestern Wisconsin. On physical examination of the patient, the physician found an engorged tick, identified as an adult femaleI scapularis, slightly embedded in the patient's back. Treatment was initiated with doxycycline, and dramatic improvement in the patient's condition was noted within 48 hours. To date, there has not been a recurrence of