The new species, which is genetically very similar to an Ehrlichia species found in Eastern Europe and Japan called E. muris, was identified at a Mayo Clinic Health System hospital in Eau Claire.Ehrlichia species are transported between cells through the host-cell filopodia during the initial stages of infection; whereas, in the final stages of infection, the pathogen ruptures the host cell membrane. Signs and symptoms
Specific symptoms include fever, chills, severe headaches, muscle aches, nausea, vomiting, diarrhea, loss of appetite, confusion, and a splotchy or pinpoint rash. More severe symptoms include brain or nervous system damage, respiratory failure, uncontrollable bleeding, organ failure, and death. Ehrlichiosis can also blunt the immune system by suppressing production of TNF-alpha, which may lead to opportunistic infections such as candidiasis.Most of the signs and symptoms of ehrlichiosis can likely be ascribed to the immune dysregulation that it causes. A "toxic shock-like" syndrome is seen in some severe cases of ehrlichiosis.
After using H&E, hematoxylin and eosin, to stain the samples, the researchers only found some inflammatory cells like neutrophils, monocytes, lymphocytes, and eosinophils. In four of the samples, immunofluorescence microscopy, where fluorescent antibodies bind to a protein of interest and the expression levels are observed through microscopy, was used but there were no signs of immunoglobulins such as IgG, IgM, IgA or C3 found. Since the first description of this condition, there were very few case reports after, indicating the infrequency of pruritic folliculitis. This was also shown by a prospective study that was conducted in 1994 by Roger et al. that concluded with one individual out of 3,192 pregnant mothers (0.03%) had symptoms which were consistent with the diagnosis of pruritic folliculitis. Pathophysiology
Folliculitis, by itself, is a common inflammation process of hair follicles in response to infection or damage to the hair follicles. This inflammatory response can be caused by bacteria, fungi, viruses, or simply ingrown hair. However, pruritic folliculitis of pregnancy is different in that it only occurs in pregnant individuals and during the second or third trimester of pregnancy. There is no clear mechanism in how pruritic folliculitis of pregnancy develops. Because this is a rare condition, there is still currently not enough research to study the cause of it. Some research suggest that this condition may be due to hormone level imbalance during pregnancy .