Epidemiological, clinical and laboratory characteristics of patients with human granulocytic anaplasmosis in Slovenia.
Human granulocytic anaplasmosis (HGA) has been recently recognized as an emerging tick-borne disease. Several reports indicate the presence of infection with Anaplasma phagocytophilum in Europe. Between January 1996 and December 2004, 24 adult patients with proven HGA were identified in a prospective study conducted at the Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia, on the etiology of febrile illnesses occurring within 30 days after a tick bite. The diagnosis of acute HGA was established from seroconversion in 18 (75%) patients or at least a four-fold increase in antibody titers to A. phagocytophilum antigens in six (25%) patients and molecular identification of ehrlichial organisms in 15 (62.5%) patients. Clinical characteristics and laboratory findings were similar to those reported from the other European countries. All the patients had an acute febrile illness with headache, malaise, myalgia and/or arthralgia. Leukopenia was found in 16 (66.7%) patients, thrombocytopenia in 20 (83.3%), abnormal liver function test results in 23 (95.8%), elevated erythrocyte sedimentation rates in 18 (75%), and elevated concentration of C-reactive protein in 23 (95.8%). The disease course was relatively mild; none of the patients died and no long-term sequelae were found during a follow-up of one year even though only 15 (62.5%) were treated with doxycycline. At the examination one year after the first visit, 16/24 (66.7%) patients tested seropositive (> or =1 : 256) for A. phagocytophilum antibody, and two years after the first visit positive titers were still present in 10/18 (55.6%) patients.
Lotric-Furlan
Stanka
S
Department of Infectious Diseases, University Medical Center Ljubljana, University of Ljubljana, Slovenia. stanka.lotric-furlan@mf.uni-lj.si
Rojko
Tereza
T
Petrovec
Miroslav
M
Avsic-Zupanc
Tatjana
T
Strle
Franc
F
D000328:Adult; D000368:Aged; D041081:Anaplasma phagocytophilum / Q000235:genetics / Q000276:immunology; D000712:Anaplasmosis / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D000907:Antibodies, Bacterial / Q000032:analysis; D021821:Communicable Diseases, Emerging; D004269:DNA, Bacterial / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D017524:Slovenia / Q000453:epidemiology
D000907:Antibodies, Bacterial; D004269:DNA, Bacterial