CASE REPORT
Clinical and molecular features of one case of human infection with Anaplasma phagocytophilum from Podlaskie Province in eastern Poland
 
More details
Hide details
1
Department of Parasitology, University of Warsaw, Poland
 
2
Department of Infectious Diseases and Neuroinfections, Medical University, Białystok, Poland
 
 
Corresponding author
Renata Welc-Falęciak   

Department of Parasitology, University of Warsaw, Poland
 
 
Ann Agric Environ Med. 2015;22(3):414-417
 
KEYWORDS
ABSTRACT
The article focuses on the clinical and laboratory diagnosis of human granulocytic anaplasmosis (HGA) caused by Anaplasma phagocytophilum infection in one of 28 patients (3.6%; n=1/28 tested samples) with early Lyme borreliosis. The clinical and laboratory results of a 42-year-old patient fulfilled criteria of confirm anaplasmosis and suggest an acute stage of illness. The described case provides strong presumptive evidence that infection in this patient was acquired with a pathogenic strain of A. phagocytophilum through a tick bite. A positive DNA with PCR for A. phagocytophilum infection was sequenced and analyzed phylogenetically. Physicians should consider the possibility of anaplasmosis in patients with early Lyme borreliosis, and A. phagocytophilum should be considered as a differential diagnosis in all patients from an endemic region of potential high risk factors for tick-borne diseases.
REFERENCES (25)
1.
Dumler JS, Choi K-S, Garcia-Garcia JC, Barat NS, Scorpio DG, Garyu JW, Grab DJ, Bakken JS. Human granulocytic anaplasmosis and Anaplasma phagocytophilum. Emerg Infect Dis. 2005; 11: 1828–1834.
 
2.
Tylewska-Wierzbanowska S, Chmielewski T, Kondrusik M, Hermanowska-Szpakowicz T, Sawicki W, Sułek K. First cases of acute human granulocytic ehrlichiosis in Poland. Eur J Clin Microbiol Infect Dis. 2001; 20: 196–198.
 
3.
Grzeszczuk A, Stanczak J, Kubica-Biernat B, Racewicz, Kruminis-Lozowska W, et al. Human anaplasmosis in north-estern Poland: seroprevalence in humans and prevalence in Ixodes ricinus ticks. Ann Agric Environ Med. 2004; 11: 99–103.
 
4.
Cisak E, Chmielewska-Badora J, Zwolinski J, Wojcik-Fatla A, Polak J, Dutkiewicz J. Risk of tick-borne bacterial diseases among workers of Roztocze National Park (south-eastern Poland). Ann Agric Environ Med. 2005; 12: 127–132.
 
5.
Chmielewska-Badora J, Moniuszko A, Zukiewicz-Sobczak W, Zwolinski J, Piątek J, et al. Serological survey in persons occupationally expose to tick-borne pathogens in cases of co-infection with Borrelia burgdorferi, Anaplasma phagocytophilum, Bartonella spp. and Babesia microti. Ann Agric Environ Med. 2012; 19: 271–274.
 
6.
Welc-Falęciak R, Hildebrandt A, Siński E. Co-infection with Borrelia species and other tick-borne pathogens in humans: two cases from Poland. Ann Agric Environ Med. 2010;17: 309–313.
 
7.
Chochlakis D, Koliou M, Ioannou I, Tselentis Y, Psaroulaki A. Kawasaki diseases and Anaplasma sp. infection in an infant, in Cyprus. Int J Infect Dis. 2009; 13: e71-e73.
 
8.
Cinco M, Barbone F, Grazia Ciufolini M, Mascioli M, Anguero Rosenfeld M, Stefanel P, et al. Seroprevalence of tick-borne infections in forestry rangers from northeastern Italy. Clin Microbiol Infect. 2004; 10: 1056–1061.
 
9.
Groen J, Koraka P, Nur YA, Avsic-Zupanc T, Goessens WH, Ott A, et al. Serologic evidence of ehrlichiosis among humans and wild animals in the Netherlands. Eur J Clin Microbiol Infect Dis. 2002; 21: 46–49.
 
10.
Blanco JR, Oteo JA. Human granulocytic ehelichiosis in Europe. Clin Microbiol Infect. 2002; 8: 763–772.
 
11.
Welc-Falęciak R, Werszko J, Cydzik K, Bajer A, Michalik J, Behnke JM. Co-infection and genetic diversity of tick-borne pathogens in roe deer from Poland. Vector-Borne Zoonotic Dis. 2013; 13: 277–288.
 
12.
Jereb M, Pecaver B, Tomazic J, Muzlovic I, Avsic-Zupanc T, Premru-Srsen T, Levicnik-Stezinar S, Karner P, Strle F. Severe human granulocytic anaplasmosis transmitted by blood transfusion. Emerg Infect Dis. 2012; 18: 1354–1357.
 
13.
Zhang L, LiuY, Ni D, Li Q, Yu Y, Yu KY, et al. Nosocomial transmission of human granulocytic anaplasmosis in China. JAMA. 2008; 300: 2263–2270.
 
14.
Horowitz HW, Kilchevsky E, Haber S, Aguero-Rosenfeld M, Krawinkel R, James EK, et. al. Peritonal transmission of the agent of the human granulocytic ehrlichiosis. N Eng J Med. 1998; 339: 375–378.
 
15.
Sumner JW, Nicholson WL, Massung RF. PCR amplification and comparison of nucleotide sequences from the groESL heat shock operon of Ehrlichia species. J Clin Microbiol. 1997; 35: 2087–2092.
 
16.
Massung RF, Slater K, Owens JH, Nicholson WL, et al. Nested PCR assay for detection of granulocytic ehrlichiae. J Clin Microbiol. 1998; 36: 1090–1095.
 
17.
CDC. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichiosis, and anaplasmosis – United State. Morbidity and Mortality Weekly Report (MMWR). 2006; RR-4.
 
18.
Kalish RA, McHugh G, Granquist J, Shea B, Ruthazer R, Steere AC. Persistence of IgM or IgG antibody responses to Borrelia burgdorferi 10 to 20 years after active Lyme disease. Clin Infect Dis. 2001; 33: 780–785.
 
19.
Chung SJ. Relationship among age, serum cholesterol level and population percentile in adults. Int J Bio-Med Comput. 1992; 31: 99–116.
 
20.
Gardner SL, Holman RC, Krebs JW, Berkelman R, Childs JE. National surveillance for the human ehrlichioses in the United States, 1997–2001, and proposed methods for evaluation of quality. Ann N Y Acad Sci. 2003; 990: 80–89.
 
21.
Lin M, Rikihisa Y. Ehrlichia chaffeensis and Anaplasma phagocytophilum lack genes for lipid A biosynthesis and incorporate cholesterol for their survival. Infect Immun. 2003; 71: 5324–5331.
 
22.
Xiong Q, Wang X, Rikihisa Y. High-choresterol diet facilitates Anaplasma phagocytophilum infection and up-regulates macrophage inflammatory protein-2 and CXCR2 expresion in apolipoprotein E-deficient mice. J Infect Dis. 2007; 195: 1497–1503.
 
23.
Katargina O, Geller J, Alekseev A, Dubinina H, Efremova G, Mishaeva N, et al. Identification of Anaplasma phagocytophilum in tick populations in Estonia, European Part of Russia and Belarus. Clin Microbiol Infect. 2012; 18: 40–46.
 
24.
Massung RF, Courtney JW, Hiratzka SL, Pitzer VE, Smith G, Dryden RL. Anaplasma phagocytophlum in white-tailed deer. Emerg Infect Dis. 2005; 1: 1604–1606.
 
25.
Grzeszczuk A. Anaplasma phagocytophilum in Ixodes ricinus ticks and human granulocytic anaplasmosis seroprivalence among forestry rangers in Bialystok region. Adv Med Sci. 2006; 51: 283–286.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top