Human granulocytic anaplasmosis A28.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

HGA; HGE; Human granulocytic ehrlichiosis

Definition
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Human granulocytic anaplasmosis (older name: human granulocytic ehrlichiosis) is a tick-borne disease caused by the Gram-negative bacterium Anaplasma phagocytophilum.

Occurrence/Epidemiology
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In Europe, few diseases have become known due to the high proportion of asymptomatic infections. Case reports from the USA, Austria, Slovenia, Portugal, Belgium and Italy are available (Hing M et al. 2018).

Clinical features
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65 to 75% of all infections are asymptomatic. After an incubation period of about 5 to 30 days, the following flu-like symptoms may occur: high fever, severe headache, malaise, nausea, vomiting, diarrhoea, muscle pain, joint pain. Less frequent are unspecific exanthema. Risk of pneumonia in immunocompromised patients.

Laboratory
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Increase in transaminases, leukocytopenia with lympho- and neutropenia, thrombopenia. C-reactive protein (CRP) and BSG increased, possible increase in CK. Detection of antibodies; titers remain high for a long time after infection.

Diagnosis
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Clinic with tick-bite history, serology

Internal therapy
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Medium of choice: Doxycycline (2x100mg/p.o. over 14 days). Alternative: Rifampicin.

Note(s)
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In view of the wide distribution of the bacterium in European ticks, a much larger number of infections can be assumed, which probably remain mostly undetected due to the lack of knowledge about the pathogen. As a result of cross-reactions, Borrelia serology can be positive.

Literature
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  1. Hing M et al (2018) Prevalence of Anaplasma phagocytophilum in humans in Belgium for the period 2013-2016 Acta Clin Belg 20:1-6.

Incoming links (1)

Ticks;

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Last updated on: 29.10.2020