Central nervous system involvement of anaplasmosis

Abstract

A 64-year-old woman presented with 24 hours of lethargy, confusion, headache, nausea and vomiting. Examination revealed expressive aphasia, conjunctival suffusion and a tick embedded in her popliteal fossa. Labs revealed hyponatraemia, transaminitis, leucopenia, thrombocytopenia and an elevated C reactive protein. Peripheral blood smear was unremarkable. MRI/magnetic resonance angiogram revealed bilateral frontoparietal subarachnoid haemorrhage which was further confirmed by lumbar puncture which revealed six nucleated cells, 92% lymphocytes, 1460 red blood cells, normal glucose and protein and negative cryptococcal antigen, herpes simplex PCR and Lyme PCR. Serum Lyme IgG/IgM antibodies and PCR, Erlichia chaffeensis serum IgG/IgM antibodies and PCR and anaplasma serum IgG/IgM antibodies were negative. Anaplasmosis serum PCR was positive. The tick was identified as Ixodes scapularis. The patient was diagnosed with anaplasmosis and treated with 21 days of doxycycline resulting in improvement of symptoms, but lingering headaches and word finding difficulties.

Severe rhabdomyolysis as a rare complication of human granulocytic anaplasmosis

“…While central nervous system (CNS) involvement in anaplasmosis is rare, cases have been documented, presenting with symptoms such as lingering aphasia and subarachnoid hemorrhage [18] . While MRI and CSF analysis may reveal nonspecific findings, treatment approaches remain consistent.…”

Severe Fatal ARDS Due to Untreated Human Granulocytic Anaplasmosis in a 67-Year-Old Man: A Case Report

“…Classic laboratory abnormalities indicative of HGA are leukopenia (present in 50% of cases), thrombocytopenia (94%) and transaminitis (90%) [8]. HGA shows seasonal variation, with most cases reported in [11] Sohani et al [12] Mullholand et al [13] Kim et al [14] Mir et al [15] Joshi et al [16] Vanicek et al [17] Ghera et al [18] Respiratory Pneumonitis spring and summer months, correlating with higher tick activity [9]. There has been at least a 20% increase in tick-borne illnesses in this decade due to climate changes leading to warmer winters and increased precipitation, favoring tick survival [9].…”