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Molecular diagnosis of autochthonous human anaplasmosis in Austria - an infectious diseases case report
Wolfgang Hoepler1, Mateusz Markowicz2, Anna-Margarita Schoetta2
14th Medical Department with Infectious Diseases and Tropical Medicine, Sozialmedizinisches Zentrum Süd - Kaiser-Franz-Josef-Spital mit Gottfried von Preyer'schem Kinderspital, KFJ-Spital, Kundratstrasse 3, 1100, Vienna, Austria. w.hoepler@gmx.at.
Background:
The diagnosis of human anaplasmosis remains elusive and is probably often missed. This case report highlights the efficacy of molecular diagnostic techniques.
Case Presentation:
We would like to report the case of a 74-year-old man who was admitted to hospital because of a high fever, marked chills, transient diplopic images and vertigo, 6 weeks after multiple tick bites. The laboratory results showed mild anemia, marked thrombocytopenia and leukopenia and a moderately elevated C-reactive protein. The initial serology seemed to indicate an active infection with Borrelia spp., and Anaplasma phagocytophilum was detected in peripheral blood by polymerase chain reaction (PCR) and subsequent sequencing. The patient received intravenous ceftriaxone for 14 days and oral doxycycline for 4 weeks and made a fast and complete recovery.
Conclusions:
While human anaplasmosis has been reported very rarely in Austria, it should be considered as a differential diagnosis in febrile patients with low leukocyte and platelet counts with elevated levels of C-reactive protein after exposure to tick bites. Molecular detection of A. phagocytophilum is the technique of choice allowing rapid and reliable diagnosis.
Insights
Human anaplasmosis, a tick-borne illness, is often missed. Molecular diagnostics like PCR offer a rapid and reliable method for identifying Anaplasma phagocytophilum infections.
Area of Science:
- Infectious Diseases
- Molecular Diagnostics
- Tick-Borne Illnesses
Background:
- Human anaplasmosis diagnosis is challenging and frequently overlooked.
- This case report emphasizes the effectiveness of molecular diagnostic methods.
Observation:
- A 74-year-old male presented with fever, chills, diplopia, and vertigo post-tick bites.
- Lab results revealed anemia, thrombocytopenia, leukopenia, and elevated C-reactive protein.
- Initial serology suggested Borrelia infection, but PCR confirmed Anaplasma phagocytophilum.
Findings:
- Polymerase chain reaction (PCR) and sequencing successfully detected Anaplasma phagocytophilum in peripheral blood.
- The patient recovered fully after treatment with ceftriaxone and doxycycline.
Implications:
- Anaplasmosis should be considered in febrile patients with cytopenias and elevated CRP after tick exposure.
- Molecular detection of Anaplasma phagocytophilum is crucial for timely and accurate diagnosis.
