[Neoehrlichiosis in rituximab-treated patients with MS in Sweden]

The emerging tick-borne infection neoehrlichiosis is underdiagnosed, and the described cases exhibit a diagnostic delay attributed to a lacking clinical awareness. Although B-cell depletion is an established risk factor for infection, only four cases of neoehrlichiosis in patients with MS have been described. We have recently presented six such cases diagnosed in southern Sweden. In one case, the patient was diagnosed twice. We here present two of these cases, as well as a summary of shared symptoms and findings. Common findings include fever, malaise, anemia and elevated CRP, but the presentation varies. The cases provide a better knowledge of neoehrlichiosis both in patients with MS and in general. As this treatable condition should be considered in patients with B-cell depleting therapy in the case of indicative symptoms, the results are important for health care providers in all fields where such therapy is used.