Direct Cultivation of the Causative Agent of Human Granulocytic Ehrlichiosis

Goodman, Jesse L.; Nelson, Curtis M.; Vitale, Blaise; Madigan, John E.; Dumler, J. Stephen; Kurtti, Timothy J.; Munderloh, Ulrike G.

doi:10.1056/nejm199601253340401

Cited by 430 publications

(398 citation statements)

References 19 publications

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“…[13][14][15][16] Thus, a history of a tick bite or well established exposure to ticks is an important historical clue. Ticks in the Ixodes persulcatus-complex serve as competent vectors for multiple pathogens that can infect humans including A. phagocytophilum, 11 Borrelia burgdorferi (the agent of Lyme borreliosis), 17 Babesia microti (the agent of babesiosis), 18 Ehrlichia muris-like agent, 19 Borrelia miyamotoi, 3 and Powassan virus 20 Vector ticks in North American endemic habitats include Ixodes scapularis in the northeastern and upper Midwest regions of the USA, and I. pacificus along the northern Pacific coast.…”

Section: Patient Historymentioning

confidence: 99%

“…41,49,50 At least 20%, and in some studies up to 100% of patients present with morulae in the cytoplasm of peripheral blood neutrophils in the first week of illness. 15,50,51 PCR amplification of A. phagocytophilum-specific DNA from acute phase blood 14,15,52 or isolation of A. phagocytophilum in HL-60 promyelocytic leukemia cell cultures inoculated with acute phase blood 13,41,53 can also confirm the diagnosis during the early stage of infection, but these test modalities are available in only a limited number of public health and commercial reference laboratories. Acute and convalescent serologic testing using an indirect fluorescent antibody method for A. phagocytophilum IgG with demonstration of four-fold change or seroconversion is the most sensitive confirmatory laboratory test, and has been used most commonly to confirm HGA.…”

Section: Diagnostic Testing and Imagingmentioning

confidence: 99%

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Human Granulocytic Anaplasmosis

Bakken

Dumler

2008

Infectious Disease Clinics of North America

164

193

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SynopsisHuman granulocytic anaplasmosis (HGA), a deer tick transmitted rickettsial infection caused by Anaplasma phagocytophilum, is a common cause of undifferentiated fever in the Northeast and Upper Midwest U.S. Patients are often initially diagnosed with a mild viral infection, and illness readily resolves in most cases. However, as many as 3% may develop life threatening complications and nearly 1% die from the infection. A history of tick bite and a high degree of clinical suspicion thus warrant consideration for doxycycline treatment in both adults and children, even in the absence of known tick bite, a negative blood film examination, or pending results of specific A. phagocytophilum diagnostic tests such as paired serology or PCR on acute phase blood. Antibody tests and titers should not be used to monitor active infection as detectable antibodies can remain present for years. Moreover, persistent infection has never been reported. While coinfections with Borrelia burgdorferi and Babesia microti occur, there is little evidence to suggest synergism of disease or a role for A. phagocytophilum in chronic illness. Preventive measures include avoiding tick-infested areas, use of tick repellents, and careful searches of skin to remove attached ticks; no vaccine is available.

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Section: Patient Historymentioning

confidence: 99%

Section: Diagnostic Testing and Imagingmentioning

confidence: 99%

Human Granulocytic Anaplasmosis

Bakken

Dumler

2008

Infectious Disease Clinics of North America

164

193

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“…These actual and potential functions are facilitated by the range of tick species from which cell lines are now available, and the well-documented ability of some of these lines to support growth of microorganisms that are not transmitted by the parent tick, or even, in the case of some arboviruses, not transmitted by ticks at all [6,10,25]. The first isolations of A. phagocytophilum from human blood were made using tick (IDE8) and human (HL60) cells [32]; although growth was initially much faster in the HL60 cells, the principle of isolating unknown pathogens using tick cells was established. Subsequently, a previously uncultivable Anaplasma sp.…”

Section: Isolation Of Pathogensmentioning

confidence: 99%

Tick cell lines: tools for tick and tick-borne disease research

Bell‐Sakyi

Zweygarth

Blouin

et al. 2007

Trends in Parasitology

161

176

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“…Ehrlichia canis (NCSU, DJ strain) was grown as described previously by in vitro propagation in the DH82-cell line [40]. Anaplasma phagocytophilum (strain 96HE158) was grown as described previously by in vitro propagation in the HL60 [14] cell line. Antigen for the IFA was prepared as previously described [14,40].…”

Section: Questionnairesmentioning

confidence: 99%

“…Anaplasma phagocytophilum (strain 96HE158) was grown as described previously by in vitro propagation in the HL60 [14] cell line. Antigen for the IFA was prepared as previously described [14,40].…”

Section: Questionnairesmentioning

confidence: 99%

A serological study of exposure to arthropod-borne pathogens in dogs from northeastern Spain

Solano‐Gallego

Llull

Osso³

et al. 2006

Vet. Res.

105

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-There is limited information regarding the prevalence of many vector borne pathogens in Europe and especially in Spanish dogs. We investigated 206 sick and 260 clinically healthy dogs from three different regions in northeastern Spain for antibodies to Rickettsia conorii (Rc), Ehrlichia canis (Ec), Anaplasma phagocytophilum (Ap), Bartonella henselae (Bh), Bartonella vinsonii subsp. berkhoffii (Bvb), Leishmania infantum (Li) and Borrelia burgdorferi (Bb) and for antigen of Dirofilaria immitis (Di). Total prevalences were the following: Rc (56.4%), Li (30%), Ec (16.7%), Bh (16.8%), Ap (11.5%), Bvb (1.07%), Di (0.6%) and Bb (0.6%). Seroprevalences for Rc, Ec, Ap, Bh, and Bvb and Bb and Di antigens were similar among the three different study sites. The Ec seroprevalence, as determined by Snap 3DX, was statistically lower in dogs from Mallorca (0%) than Tarragona (16%) and Barcelona (5%) (P < 0.0001). Detection of Rc antibodies was associated with seroreactivity to Ec and Ap antigens (P = 0.018 and P = 0.002, respectively). IFA Ec antibodies were associated with Ap seroreactivity (P < 0.0001). There was no association between the clinical status, sex, time of the year when samples were collected, life-style or exposure to fleas or ticks and a positive test result for Ec, Bh, Bvb, or Bb antibodies or Di antigens. Li seroreactivity was associated with illness and living outdoors (P < 0.0001, P = 0.029; respectively), Rc seroreactivity with the male gender (P = 0.028) and Ap seroreactivity with living outdoors (P = 0.045). This study indicates that exposure to Rc, Li, Ec or related Ehrlichia spp., Bh and Ap or a related spp., is common whereas Di, Bb and Bvb is uncommon among dogs from the Mediterranean basin. We also provide serological data that suggests the existence of a novel Ehrlichia species on Mallorca island. rickettsial pathogens / dogs / Spain

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Direct Cultivation of the Causative Agent of Human Granulocytic Ehrlichiosis

Abstract: We describe the cultivation of the agent of human granulocytic ehrlichiosis in cell culture. The ability to isolate this organism should lead to a better understanding of the biology, treatment, and epidemiology of this emerging infection.

Cited by 430 publications

References 19 publications

Human Granulocytic Anaplasmosis

Human Granulocytic Anaplasmosis

Tick cell lines: tools for tick and tick-borne disease research

A serological study of exposure to arthropod-borne pathogens in dogs from northeastern Spain

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