Brachial plexopathy associated with human granulocytic ehrlichiosis

Human granulocytic ehrlichiosis is a tick-borne disease of humans. Involvement of the peripheral nervous system is well known with Lyme disease and some rickettsioses but has yet to be described with this disease. We describe a man with bilateral brachial plexopathies associated with an acute febrile illness and clinical, laboratory, and serologic evidence diagnostic of human granulocytic ehrlichiosis. The clinical presentation suggests that the peripheral neuropathy was postinfectious. Human granulocytic ehrlichiosis should be considered in the differential diagnosis in patients with peripheral nervous system involvement, including brachial plexopathy, of individuals who live or recreate in areas known to harbor ticks.