Simultaneous Human Granulocytic Ehrlichiosis and Lyme Borreliosis

Nadelman, Robert B.; Horowitz, Harold W.; Hsieh, Tze‐chen; Wu, Joseph M.; Agüero-Rosenfeld, Maria E.; Schwartz, Ira; Nowakowski, John; Varde, Shobha; Wormser, Gary P.

doi:10.1056/nejm199707033370105

Cited by 178 publications

(107 citation statements)

References 17 publications

Supporting

Mentioning

105

Contrasting

Order By: Relevance

“…In tick-infested areas of North America, Lyme borreliosis and HGE often coexist where I. pacificus and I. scapularis abound [21,22]. Co-infections in man have been verified by culture methods [23] and suggested by the co-existence of antibodies to B. burgdorferi and A. phagocytophila in the same host [20,24,25]. The HGE patient in the present study had not been diagnosed previously with Lyme borreliosis, but there was reactivity of the patient's serum with p22, p41-G, OspF and VlsE antigens.…”

Section: Discussionmentioning

confidence: 99%

Comparative reactivity of human sera to recombinant VlsE and other Borrelia burgdorferi antigens in class-specific enzyme-linked immunosorbent assays for Lyme borreliosis

Magnarelli

Lawrenz

Norris

et al. 2002

Journal of Medical Microbiology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Comparative reactivity of human sera to recombinant VlsE and other Borrelia burgdorferi antigens in class-specific enzyme-linked immunosorbent assays for Lyme borreliosis

Magnarelli

Lawrenz

Norris

et al. 2002

Journal of Medical Microbiology

View full text Add to dashboard Cite

“…In fact, simultaneous human infection with the two agents has already been reported, 27 and it may lead to variations in clinical symptoms and signs. 28,29 If one considers that A. phagocytophila can cause immunosuppression in its mammalian hosts, coinfection with two or more tick-borne agents may aggravate the clinical pictures of Lyme disease and tick-borne encephalitis. The identification of A. phagocytophila in I. persulcatus, and the finding of coinfection with B. burgdorferi in the current study imply that the possible occurrence of ehrlichiosis should be considered in the differential diagnosis of febrile patients with a history of tick bite in the forest areas of northeastern China, particularly when clinical manifestations are atypical for Lyme disease.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anaplasma Phagocytophila and Borrelia Burgdorferi in Ixodes Persulcatus Ticks From Northeastern China

Cao

Zhao

Zhang

et al. 2003

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. A total of 1,345 Ixodes persulcatus ticks collected from northeastern China were investigated for the presence of Anaplasma phagocytophila and Borrelia burgdorferi by a nested polymerase chain reaction (PCR). Sixty-two (4.6%) ticks were positive for A. phagocytophila and 454 (33.8%) were positive for B. burgdorferi. Seven (0.5%) were coinfected with both agents. Sequence analysis of 919-basepair PCR amplicons revealed three types of A. phagocytophila. Type 1 was identical to the published sequences of A. phagocytophilas responsible for human granulocytic ehrlichiosis (HGE). The other two variants differed from the HGE agent sequence at one and four positions, respectively. These findings imply that infection with A. phagocytophila poses a potential health threat to both humans and animals in northeastern China, and that ehrlichiosis should be considered in the differential diagnosis of febrile patients with a history of tick bite, particularly when clinical manifestations are atypical for Lyme disease.

show abstract

“…Doxycycline 100 mg twice a day is found to be the most effective therapy, it can be the treatment of choice also in children [3,4]. Usually it is prescribed orally for 14 days, but no universal data are available [4,15,23].…”

Section: Anaplasma Phagocytophilummentioning

confidence: 99%