Human granulocytic ehrlichiosis in Slovenia

Several reports indicate the presence of infection with Anaplasma phagocytophila in Europe. The first case with confirmed human granulocytic ehrlichiosis was reported from Slovenia in 1997. By 2002, 13 patients have been discovered in a prospective study on the etiology of febrile illnesses occurring within six weeks following a tick bite, conducted at the Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia. The diagnosis was established by molecular identification of ehrlichial organisms and/or by seroconversion to A. phagocytophila. None of the patients had detectable morulae on blood smear examination. Clinical characteristics and laboratory findings were similar to those reported from the United States. The severity of the illness was mild to moderately severe. All patients recovered rapidly and without sequelae. HGE should be included in the differential diagnosis of febrile illnesses occurring after a tick bite in Slovenia.