Serial Measurements of Hematologic Counts during the Active Phase of Human Granulocytic Ehrlichiosis

Bakken, Johan S.; Agüero-Rosenfeld, Maria E.; Tilden, Robert L.; Wormser, Gary P.; Horowitz, Harold W.; Raffalli, John; Baluch, Mehdi; Riddell, D. O.; Walls, Jennifer J.; Dumler, J. Stephen

doi:10.1086/319350

Cited by 106 publications

(82 citation statements)

References 22 publications

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“…Characteristic laboratory findings in anaplasmosis include thrombocytopenia, leukopenia, elevated hepatic transaminase levels, increased numbers of immature neutrophils, and mild anemia (169). Similar to ehrlichiosis, lymphocytosis can be present during the recovery period (170).…”

Section: Laboratory Findingsmentioning

confidence: 99%

Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States

Biggs¹,

Behravesh²,

et al. 2016

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Section: Laboratory Findingsmentioning

confidence: 99%

Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States

Biggs¹,

Behravesh²,

et al. 2016

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“…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.…”

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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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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“…4,17,18 For severely ill cases, polymerase chain reaction (PCR) is highly sensitive for testing DNA extracted from whole blood specimens. 19 Cases presenting early in the clinical course with less severe disease may have fewer organisms circulating and while PCR is highly specific, its sensitivity may be low (70%).…”

mentioning

confidence: 99%

Human Granulocytic Anaplasmosis in the United States from 2008 to 2012: A Summary of National Surveillance Data

Dahlgren¹,

Heitman²,

Drexler³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Human granulocytic anaplasmosis is an acute, febrile illness transmitted by the ticks Ixodes scapularis and Ixodes pacificus in the United States. We present a summary of passive surveillance data for cases of anaplasmosis with onset during 2008-2012. The overall reported incidence rate (IR) was 6.3 cases per million person-years. Cases were reported from 38 states and from New York City, with the highest incidence in Minnesota (IR = 97), Wisconsin (IR = 79), and Rhode Island (IR = 51). Thirty-seven percent of cases were classified as confirmed, almost exclusively by polymerase chain reaction. The reported case fatality rate was 0.3% and the reported hospitalization rate was 31%. IRs, hospitalization rates, life-threatening complications, and case fatality rates increased with age group. The IR increased from 2008 to 2012 and the geographic range of reported cases of anaplasmosis appears to have increased since 2000-2007. Our findings are consistent with previous case series and recent reports of the expanding range of the tick vector I. scapularis.

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Serial Measurements of Hematologic Counts during the Active Phase of Human Granulocytic Ehrlichiosis

Cited by 106 publications

References 22 publications

Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States

Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis — United States

Human Granulocytic Anaplasmosis

Human Granulocytic Anaplasmosis in the United States from 2008 to 2012: A Summary of National Surveillance Data

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