Human granulocytotropic anaplasmosis: Difference between revisions
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#REDIRECT [[Anaplasma phagocytophilum]] |
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== Microbiology == |
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* Small, obligate intracellular Gram-negative bacterium |
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* Related to Ehrlichia and Rickettsiae |
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* Tropism for neutrophils |
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== Clinical Presentation == |
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* Incubation period of 1 to 2 weeks |
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* Usually an acute undifferentiated fever |
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* Can be mild or severe |
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* Fever, headache, malaise, and myalgias are common |
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* Can also cause nausea, vomiting, diarrhea, cough, arthralgias, nuchal rigidity, and confusion |
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* Less than 10% have rash, most of which is concurrent Lyme disease |
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* 36% of cases require hospitalization, and it is severe in 3 to 7% |
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* Severe complications include respiratory failure, septic shock, rhabdomyolysis, hemorrhage, and opportunistic infections |
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** Rare meningoencephalitis |
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* Higher case-fatality rate in Shandong Province in China, for no clear reason (16% versus 2.6%) |
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* Thrombocytopenia, lerkopenia, and mild anemia are common |
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** Return to normal range within 14 days, but with persistent left shift |
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* Abnormal liver enzymes are common in the first 7 days |
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== Diagnosis == |
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* 20-80% of patients will have circulating neutrophils with detectable '''morulae''' on blood film (in neutrophils/granulocytes) |
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* Serology used to diagnose, by measuring IgG levels ≥1:64 or a fourfold rise |
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** IgM testing less sensitive and specific |
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* Culture not done routinely |
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* PCR possible |
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== Management == |
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* Doxycycline 100 mg po bid |
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Latest revision as of 17:42, 13 August 2019
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