Infections With the Tick-Borne Bacterium 'Candidatus Neoehrlichia mikurensis' Mimic Noninfectious Conditions in Patients With B Cell Malignancies or Autoimmune Diseases
| Autor: | Christine Wennerås, Per-Ola Andersson, Anna Grankvist, Monica Sender, Martin Stenson, Jan Fehr, Estelle Trysberg, Krista Vaht, Mattias Mattsson, Linnea Höper, Egidija Sakiniene, Sona Pekova, Christian Bogdan, Guido V. Bloemberg |
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| Přispěvatelé: | University of Zurich, Wennerås, Christine |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty medicine.medical_treatment Splenectomy 610 Medicine & health 2726 Microbiology (medical) 10234 Clinic for Infectious Diseases Pharmacotherapy Medizinische Fakultät Internal medicine medicine Leukocytosis ddc:610 Hematology 10179 Institute of Medical Microbiology business.industry food and beverages 2725 Infectious Diseases Neutrophilia Infectious Diseases Infectious disease (medical specialty) Immunology Candidatus 570 Life sciences biology medicine.symptom business Infectious Disease Medicine |
| Popis: | 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 Both published (6) and unpublished cases (5) were included.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. |
| Databáze: | OpenAIRE |
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