Successful treatment of human granulocytic ehrlichiosis in children using rifampin

Human granulocytic ehrlichiosis (HGE) is an emerging tick-borne infectious disease caused by Anaplasma phagocytophilum. Clinical features include a flu-like illness that usually resolves within 1 week. More serious infection may occur that requires hospital admission or culminates in death. Doxycycline is the treatment of choice for HGE but may cause permanent staining of teeth in children younger than 8 years of age. We report successful treatment of HGE with rifampin in 2 children, 4 and 6 years old. A course of rifampin for 5 to 7 days should be considered in children younger than 8 years of age who experience non-life-threatening A phagocytophilum infection.