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Cerebrospinal Fluid Findings among Patients with Anaplasmosis and Central Nervous Involvement, Minnesota and

Igor Dumic, Charles W Nordstrom, Marie Schulz

    Emerging Infectious Diseases
    |June 2, 2026
    PubMed

    Insights

    Anaplasmosis rarely affects the central nervous system, and its cerebrospinal fluid (CSF) profile is unclear. This study found CSF abnormalities in anaplasmosis patients with neurological symptoms were mild and improved with doxycycline.

    Area of Science:

    • Infectious Diseases
    • Neurology
    • Public Health

    Background:

    • Anaplasmosis is an emerging tickborne zoonosis with infrequent central nervous system (CNS) involvement.
    • Cerebrospinal fluid (CSF) profiles in neuroanaplasmosis are poorly understood.
    • Understanding CNS involvement is crucial for diagnosing and managing this potentially severe infection.

    Purpose of the Study:

    • To characterize the cerebrospinal fluid (CSF) findings in patients with neuroanaplasmosis.
    • To correlate CSF profiles with neurologic severity.
    • To evaluate the effectiveness of empiric doxycycline therapy.

    Main Methods:

    • Retrospective, multisite study of hospitalized anaplasmosis patients with neurologic symptoms and lumbar puncture.
    • Anaplasmosis confirmation by PCR on blood samples.
    • Analysis of CSF parameters including cell counts, glucose, and protein levels.

    Main Results:

    • Ten patients met inclusion criteria, presenting with meningitis, meningoencephalitis, or encephalitis.
    • Five patients had normal CSF; four showed mild lymphocytic pleocytosis without abnormal glucose or protein.
    • CSF abnormalities did not correlate with neurologic severity, suggesting a cytokine-mediated inflammatory response.

    Conclusions:

    • Neuroanaplasmosis can present with subtle or normal CSF findings.
    • The pathogenesis may involve a cytokine-mediated process rather than direct CNS infection.
    • Prompt recognition and empiric doxycycline treatment are essential for favorable outcomes in neuroanaplasmosis.
    Keywords:
    Anaplasma phagocytophilumAnaplasmosisMinnesotaUnited StatesWisconsinbacteriacerebrospinal fluidmeningitis/encephalitistickborne diseasevector-borne infectionszoonoses

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