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Human granulocytic anaplasmosis in eastern France: clinical presentation and laboratory diagnosis
Christelle Koebel1, Aurélie Kern, Sophie Edouard
1Laboratoire de Bactériologie, Hôpitaux Universitaires de Strasbourg, 1, rue Koeberlé, Strasbourg Cedex, France.
Abstract:
Human granulocytic anaplasmosis (HGA) is a tick-borne infection characterised by an acute, nonspecific febrile illness. To date, few clinical cases have been supported by both a positive polymerase chain reaction (PCR) assay and subsequent seroconversion against Anaplasma phagocytophilum antigen all over Europe. We report here 3 consecutive cases of HGA that occurred during the summer of 2009 which fulfilled the epidemiologic, clinical, and biological criteria for HGA. These data highlight PCR assay on ethylenediaminetetraacetic acid blood rather than serology as the diagnostic test of choice during the acute phase of the disease. In endemic areas, HGA should be investigated in patients presenting an undifferentiated febrile illness with cytopenia, elevated rates of liver enzymes, and increased C-reactive protein values.
Insights
Human granulocytic anaplasmosis (HGA) is a tick-borne illness. Polymerase chain reaction (PCR) blood tests are more effective than serology for diagnosing HGA during the acute phase.
Area of Science:
- Infectious Diseases
- Microbiology
- Tick-borne Illnesses
Background:
- Human granulocytic anaplasmosis (HGA) is an acute, nonspecific febrile illness transmitted by ticks.
- Few European cases have confirmed HGA via both PCR and seroconversion.
- Anaplasma phagocytophilum is the causative agent of HGA.
Observation:
- Three consecutive HGA cases occurred in the summer of 2009.
- Cases met epidemiological, clinical, and biological criteria for HGA.
- Patients presented with undifferentiated febrile illness, cytopenia, elevated liver enzymes, and increased C-reactive protein.
Findings:
- Polymerase chain reaction (PCR) assay on ethylenediaminetetraacetic acid (EDTA) blood is the preferred diagnostic method during acute HGA.
- Serology is less reliable for diagnosing HGA in the acute phase.
- HGA diagnosis should be considered in endemic areas for febrile illnesses with specific clinical and laboratory findings.
Implications:
- Highlights the diagnostic utility of PCR for acute HGA.
- Suggests HGA should be investigated in patients with unexplained febrile illness and cytopenia.
- Emphasizes the importance of considering HGA in differential diagnoses for febrile patients in endemic regions.
