Infections with the tick-borne bacterium "Candidatus Neoehrlichia mikurensis" mimic noninfectious conditions in patients with B cell malignancies or autoimmune diseases
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
24647019
DOI
10.1093/cid/ciu189
PII: ciu189
Knihovny.cz E-resources
- Keywords
- B-cell malignancies, human, infection, Neoehrlichia, tick-borne,
- MeSH
- Aneurysm microbiology MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Autoimmune Diseases microbiology MeSH
- C-Reactive Protein metabolism MeSH
- DNA, Bacterial blood MeSH
- Hematologic Neoplasms microbiology MeSH
- Fever microbiology MeSH
- Anaplasmataceae Infections complications diagnosis drug therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Musculoskeletal Pain microbiology MeSH
- Tick-Borne Diseases complications diagnosis drug therapy microbiology MeSH
- Communicable Diseases, Emerging diagnosis drug therapy microbiology MeSH
- Delayed Diagnosis MeSH
- Pulmonary Embolism microbiology MeSH
- Aged MeSH
- Splenectomy MeSH
- Ischemic Attack, Transient microbiology MeSH
- Venous Thrombosis microbiology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Anti-Bacterial Agents MeSH
- C-Reactive Protein MeSH
- DNA, Bacterial MeSH
BACKGROUND: Candidatus Neoehrlichia mikurensis is a newly discovered noncultivatable bacterium spread among ticks and rodents in Europe and Asia that can infect humans, particularly immunocompromised patients. METHODS: We compiled clinical and laboratory data from 11 patients with hematological malignances or autoimmune diseases who were diagnosed with Candidatus N. mikurensis infection in Europe 2010-2013. Both published (6) and unpublished cases (5) were included. RESULTS: The patients had a median age of 67, were mostly male (8/11), and resided in Sweden, Switzerland, Germany, and the Czech Republic. All but one had ongoing or recent immune suppressive treatment and a majority were splenectomized (8/11). Less than half of them recalled tick exposure. The most frequent symptoms were fever (11/11), localized pain afflicting muscles and/or joints (8/11), vascular and thromboembolic events (6/11), that is, deep vein thrombosis (4), transitory ischemic attacks (2), pulmonary embolism (1), and arterial aneurysm (1). Typical laboratory findings were elevated C-reactive protein, leukocytosis with neutrophilia, and anemia. Median time from onset of symptoms to correct diagnosis was 2 months. In at least 4 cases, the condition was interpreted to be due to the underlying disease, and immunosuppressive therapy was scheduled. All patients recovered completely when doxycycline was administered. CONCLUSIONS: Candidatus N. mikurensis is an emerging tick-borne pathogen that may give rise to a systemic inflammatory syndrome in persons with hematologic or autoimmune diseases that could be mistaken for recurrence of the underlying disease and/or unrelated arteriosclerotic vascular events. Awareness of this new pathogen is warranted among rheumatologists, hematologists, oncologists, and infectious disease specialists.
Department of Hematology and Coagulation Sahlgrenska University Hospital Göteborg
Department of Internal Medicine Karlstad Hospital Karlstad
Department of Medicine Kungälv Hospital Kungälv Sweden
Department of Rheumatology Sahlgrenska University Hospital Göteborg
Institute of Medical Microbiology University of Zurich Zurich Switzerland
Laboratory for Molecular Diagnostics CHAMBON Laboratories Prague Czech Republic
References provided by Crossref.org
Putative morphology of Neoehrlichia mikurensis in salivary glands of Ixodes ricinus
Multilocus Sequence Analysis of Clinical "Candidatus Neoehrlichia mikurensis" Strains from Europe
