Human granulocytic ehrlichiosis (HGE) is an emerging infectious disease that primarily affects adults. Typical clinical features include fever, headache, and myalgias. This case represents the youngest reported patient with HGE. Her clinical presentation was unusual in that she presented with severe abdominal pain. In addition, she did not develop the typical spectrum of laboratory abnormalities that has been reported in adults. This patient's course suggests that the presentation of HGE may be more varied than previously reported.