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 Both published (6) and unpublished cases (5) were included.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.
- MeSH
- aneurysma mikrobiologie MeSH
- antibakteriální látky terapeutické užití MeSH
- autoimunitní nemoci mikrobiologie MeSH
- C-reaktivní protein metabolismus MeSH
- DNA bakterií krev MeSH
- hematologické nádory mikrobiologie MeSH
- horečka mikrobiologie MeSH
- infekce bakteriemi čeledi Anaplasmataceae komplikace diagnóza farmakoterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- muskuloskeletální bolest mikrobiologie MeSH
- nemoci přenášené klíšťaty komplikace diagnóza farmakoterapie mikrobiologie MeSH
- objevující se infekční nemoci diagnóza farmakoterapie mikrobiologie MeSH
- opožděná diagnóza MeSH
- plicní embolie mikrobiologie MeSH
- senioři MeSH
- splenektomie MeSH
- tranzitorní ischemická ataka mikrobiologie MeSH
- žilní trombóza mikrobiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Hematooncologic patients often host rare or fastidious pathogens. Using 16S rDNA sequencing and transmission electron microscopy, we have identified 2 lymphoma patients infected with Candidatus Neoehrlichia mikurensis. In both individuals, the clinical presentation suggested ehrlichiosis-like syndrome. We believe that molecular techniques open new vistas in the field of pathogen detection.
- MeSH
- Anaplasmataceae klasifikace genetika izolace a purifikace MeSH
- diagnostické techniky molekulární MeSH
- DNA bakterií genetika MeSH
- ehrlichióza diagnóza MeSH
- elektronová mikroskopie MeSH
- hematologické nádory komplikace MeSH
- horečka neznámého původu diagnóza mikrobiologie MeSH
- hostitel s imunodeficiencí MeSH
- infekce bakteriemi čeledi Anaplasmataceae komplikace diagnóza MeSH
- klíšťata mikrobiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- polymerázová řetězová reakce MeSH
- ribozomální DNA genetika MeSH
- sekvenční analýza DNA MeSH
- zvířata MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
