title: First documented case of human granulocytic ehrlichiosis in Austria.
abstract: We report the first documented case of human granulocytic ehrlichiosis (HGE) in Austria. The infection was acquired near Arzl in the surroundings of Innsbruck in northern Tyrol. Except for a biphasic course of illness, presentation in this 33-year-old female patient was comparable to clinical findings observed in other European adults with high fever, transient thrombocytopenia, elevated levels of CRP and LDH, arthralgias, myalgias, fatigue and subfebrile temperature. Flu-like symptoms started about seven days after a tick bite and lasted for ten days, followed by an asymptomatic interval of three days and an acute onset of fever up to 39.5 degrees C on day 20. On admission, the patient showed high antibody titres against Anaplasma phagocytophilum (IgG 1:1024, IgM 1:640); six weeks later the IgG-titre had risen to 1:2048, and IgM-levels had fallen below 1:40. The demonstration of anti-platelet antibodies in acute-phase serum was noteworthy. We conclude that also in Austria HGE should be considered in patients with febrile thrombocytopenia, especially when the medical history reveals recent tick exposure.
authors.affiliation: Institut für Hygiene und Sozialmedizin, Universität Innsbruck, Innsbruck, Austria. gernot.walder@uibk.ac.at
authors.forename: Gernot
authors.initials: G
authors.lastname: Walder
authors.forename: Barbara
authors.initials: B
authors.lastname: Falkensammer
authors.forename: Johannes
authors.initials: J
authors.lastname: Aigner
authors.forename: Gerhard
authors.initials: G
authors.lastname: Tiwald
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Dierich
authors.forename: Reinhard
authors.initials: R
authors.lastname: Würzner
authors.forename: Peter
authors.initials: P
authors.lastname: Lechleitner
mesh_terms: D000328:Adult; D041081:Anaplasma phagocytophilum / Q000276:immunology; D000907:Antibodies, Bacterial / Q000097:blood; D001317:Austria; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000627:therapeutic use; D016873:Ehrlichiosis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D010976:Platelet Count
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D004318:Doxycycline