Anchoring on COVID-19: A Case Report of Human Granulocytic Anaplasmosis Masquerading as COVID-19

Introduction: Human granulocytic anaplasmosis (HGA) is caused by Anaplasma phagocytophilum and transmitted through the deer tick. Most cases are mild and can be managed as an outpatient, but rare cases can produce severe symptoms. Case Report: A 43-year-old male presented with severe respiratory distress mimicking coronavirus disease 2019 (COVID-19). Labs and imaging were consistent with COVID-19; however, polymerase chain reaction was negative twice. Peripheral smear revealed inclusion bodies consistent with HGA. Conclusion: Human granulocytic anaplasmosis is an uncommon diagnosis and rarely causes severe disease. Recognition of unique presentations can aid in quicker diagnosis, especially when mimicking presentations frequently seen during the COVID-19 pandemic.

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Case Report: Polymerase Chain Reaction Testing of Tick Bite Site Samples for the Diagnosis of Human Granulocytic Anaplasmosis

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.16-0570 ◽

2017 ◽

Vol 97 (2) ◽

pp. 403-406 ◽

Cited By ~ 5

Author(s):

Choon-Mee Kim ◽

Na-Ra Yoon ◽

Seung Hun Lee ◽

Piyush Jha ◽

Seok Won Kim ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Case Report ◽

Tick Bite ◽

Chain Reaction ◽

Human Granulocytic Anaplasmosis ◽

Polymerase Chain Reaction Testing ◽

Granulocytic Anaplasmosis ◽

Polymerase Chain

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The first serological evidence of Anaplasma phagocytophilum in horses in Slovakia

Acta Veterinaria Hungarica ◽

10.1556/004.2021.00007 ◽

2021 ◽

Author(s):

Monika Drážovská ◽

Boris Vojtek ◽

Jana Mojžišová ◽

Simona Koleničová ◽

Filip Koľvek ◽

...

Keyword(s):

Anaplasma Phagocytophilum ◽

Immunofluorescence Assay ◽

Pcr Analysis ◽

Rrna Gene ◽

Serological Evidence ◽

Emerging Pathogens ◽

Chain Reaction ◽

Granulocytic Anaplasmosis ◽

Different Ages ◽

Polymerase Chain

AbstractAnaplasma phagocytophilum is the causative agent of granulocytic anaplasmosis. It affects humans and several wild and domesticated mammals, including horses. The aim of our study was a preliminary survey of the occurrence of these re-emerging pathogens in horses in Slovakia. The sera from 200 animals of different ages and both sexes were tested for the presence of A. phagocytophilum antibodies by indirect immunofluorescence assay. Subsequently, detection of the 16S rRNA gene fragment of A. phagocytophilum was attempted by polymerase chain reaction (PCR) in each blood sample. Our results confirmed the presence of specific antibodies in 85 out of 200 individuals (42.5%), but no significant changes were found between the animals of different ages and sexes. However, the PCR analysis did not detect any positive animals. Our data represent one of the highest values of seropositivity to A. phagocytophilum in horses in Central Europe. These results may contribute to a better understanding of the circulation of A. phagocytophilum in this region, thus indicating a potential risk to other susceptible species.

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Granulocytic anaplasmosis in captive ring-tailed lemur (Lemur catta) in Poland

BMC Veterinary Research ◽

10.1186/s12917-021-02827-8 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Łukasz Adaszek ◽

Anna Wilczyńska ◽

Jerzy Ziętek ◽

Marcin Kalinowski ◽

Oliwier Teodorowski ◽

...

Keyword(s):

Anaplasma Phagocytophilum ◽

Polymerase Chain Reaction Test ◽

Anaplasma Ovis ◽

Case Presentation ◽

Granulocytic Anaplasmosis ◽

Pcr Product ◽

Polymerase Chain ◽

Obligate Intracellular Bacteria ◽

Chain Reaction Test ◽

Anaplasma Bovis

Abstract Background Anaplasma are obligate intracellular bacteria and aetiological agents of tick-borne diseases of both veterinary and medical interest. The genus Anaplasma comprises six species: Anaplasma marginale, Anaplasma centrale, Anaplasma ovis, Anaplasma phagocytophilum, Anaplasma bovis and Anaplasma platys. They can infect humans, carnivores, ruminants, rodents, insectivores, birds and reptiles. The aim of this study was to present the first clinical case of granulocytic anaplasmosis in a captive ring-tailed lemur in Poland. Case presentation A 4-year-old female lemur presented anorexia, epistaxis and tick infestation. The microscopic examination of a blood smear revealed morulae in neutrophils. Polymerase chain reaction test and sequencing of obtained PCR product confirmed infection by the GU183908 Anaplasma phagocytophilum strain. Therapeutic protocol included doxycycline (2.5 mg/kg p.o., b.i.d.) for 3 weeks and the lemur recovered within 24 h. Conclusions This is the first report on granulocytic anaplasmosis in a ring-tailed lemur in Europe, indicating that A. phagocytophilum infection must also be considered in differential diagnosis in this animal species, especially in individuals with thrombocytopenia associated with Ixodes ricinus parasitism.

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A real-time combined polymerase chain reaction assay for the rapid detection and differentiation of Anaplasma phagocytophilum, Ehrlichia chaffeensis, and Ehrlichia ewingii

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2005.06.019 ◽

2005 ◽

Vol 53 (4) ◽

pp. 301-306 ◽

Cited By ~ 35

Author(s):

Constance A. Bell ◽

Robin Patel

Keyword(s):

Polymerase Chain Reaction ◽

Real Time ◽

Anaplasma Phagocytophilum ◽

Polymerase Chain Reaction Assay ◽

Rapid Detection ◽

Ehrlichia Chaffeensis ◽

Chain Reaction ◽

Polymerase Chain

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On-column Refolding of an Insoluble His6-tagged Recombinant EC-SOD Overexpressed in Escherichia coli

Acta Biochimica et Biophysica Sinica ◽

10.1111/j.1745-7270.2005.00035.x ◽

2005 ◽

Vol 37 (4) ◽

pp. 265-269 ◽

Cited By ~ 11

Author(s):

Xi-Qiang Zhu ◽

Su-Xia Li ◽

Hua-Jun He ◽

Qin-Sheng Yuan

Keyword(s):

Escherichia Coli ◽

Inclusion Bodies ◽

Mass Ratio ◽

Chain Reaction ◽

Expression Plasmid ◽

Protein Subunits ◽

E Coli ◽

Metal Affinity ◽

Polymerase Chain ◽

Escherichia Coli Expression

Abstract The EC-SOD cDNA was cloned by polymerase chain reaction (PCR) and inserted into the Escherichia coli expression plasmid pET-28a(+) and transformed into E. coli BL21(DE3). The corresponding protein that was overexpressed as a recombinant His6-tagged EC-SOD was present in the form of inactive inclusion bodies. This structure was first solubilized under denaturant conditions (8.0 M urea). Then, after a capture step using immobilized metal affinity chromatography (IMAC), a gradual refolding of the protein was performed on-column using a linear urea gradient from 8.0 M to 1.5 M in the presence of glutathione (GSH) and oxidized glutathione (GSSG). The mass ratio of GSH to GSSG was 4:1. The purified enzyme was active, showing that at least part of the protein was properly refolded. The protein was made concentrated by ultrafiltration, and then isolated using Sephacryl S-200 HR. There were two protein peaks in the A280 profile. Based on the results of electrophoresis, we concluded that the two fractions were formed by protein subunits of the same mass, and in the fraction where the molecular weight was higher, the dimer was formed through the disulfide bond between subunits. Activities were detected in the two fractions, but the activity of the dimer was much higher than that of the single monomer. The special activities of the two fractions were found to be 3475 U/mg protein and 510 U/mg protein, respectively.

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CXCR2 Blockade Influences Anaplasma phagocytophilum Propagation but Not Histopathology in the Mouse Model of Human Granulocytic Anaplasmosis

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.11.5.963-968.2004 ◽

2004 ◽

Vol 11 (5) ◽

pp. 963-968 ◽

Cited By ~ 34

Author(s):

Diana G. Scorpio ◽

Mustafa Akkoyunlu ◽

Erol Fikrig ◽

J. Stephen Dumler

Keyword(s):

Anaplasma Phagocytophilum ◽

Tissue Injury ◽

Treated Group ◽

Obligate Intracellular Bacterium ◽

Human Granulocytic Anaplasmosis ◽

Obligate Intracellular ◽

Liver Histopathology ◽

Granulocytic Anaplasmosis ◽

Infected Cells ◽

And Control

ABSTRACT Anaplasma phagocytophilum is an obligate intracellular bacterium that infects neutrophils and causes human granulocytic anaplasmosis. Infection induces neutrophil secretion of interleukin-8 or murine homologs and perpetuates infection by recruiting susceptible neutrophils. We hypothesized that antibody blockade of CXCR2 would decrease A. phagocytophilum tissue load by interrupting neutrophil recruitment but would not influence murine hepatic pathology. C3H-scid mice were treated with CXCR2 antiserum or control prior to or on day 14 after infection. Quantitative PCR and immunohistochemistry for A. phagocytophilum were performed and severity of liver histopathology was ranked. Control mice had more infected cells in tissues than the anti-CXCR2-treated group. The histopathological rank was not different between treated and control animals. Infected cells of control mice clustered in tissue more than in treated mice. The results support the hypothesis of bacterial propagation through chemokine induction and confirm that tissue injury is unrelated to A. phagocytophilum tissue load.

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Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases

Viruses ◽

10.3390/v13030512 ◽

2021 ◽

Vol 13 (3) ◽

pp. 512

Author(s):

Szilárd Váncsa ◽

Fanni Dembrovszky ◽

Nelli Farkas ◽

Lajos Szakó ◽

Brigitta Teutsch ◽

...

Keyword(s):

Individual Patient Data ◽

Case Reports ◽

Severe Disease ◽

Descriptive Analysis ◽

Case Series ◽

Disease Course ◽

Chain Reaction ◽

Baseline Characteristics ◽

Polymerase Chain ◽

Meta Analyses

Repeated positivity and reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a significant concern. Our study aimed to evaluate the clinical significance of repeatedly positive testing after coronavirus disease 2019 (COVID-19) recovery. We performed a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. With available individual patient data reporting on repeatedly SARS-CoV-2 positive (RSP) patients, case reports, and case series were included in this analysis. We performed a descriptive analysis of baseline characteristics of repeatedly positive cases. We assessed the cases according to the length of their polymerase chain reaction (PCR) negative interval between the two episodes. Risk factors for the severity of second episodes were evaluated. Overall, we included 123 patients with repeated positivity from 56 publications, with a mean repeated positivity length of 47.8 ± 29.9 days. Younger patients were predominant in the delayed (>90 days) recurrent positive group. Furthermore, comparing patients with RSP intervals of below 60 and above 60 days, we found that a more severe disease course can be expected if the repeated positivity interval is shorter. Severe and critical disease courses might predict future repeatedly positive severe and critical COVID-19 episodes. In conclusion, our results show that the second episode of SARS-CoV-2 positivity is more severe if it happens within 60 days after the first positive PCR. On the other hand, the second episode’s severity correlates with the first.

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Case Report: Progressive Dysphonia and Dysphagia due to Laryngeal Leishmaniasis

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.20-1466 ◽

2021 ◽

Author(s):

Laura Renard ◽

Adrien Lemaignen ◽

Guillaume Desoubeaux ◽

David Bakhos

Keyword(s):

Polymerase Chain Reaction ◽

Weight Loss ◽

Case Report ◽

Amphotericin B ◽

Laryngeal Cancer ◽

Complete Resolution ◽

Chain Reaction ◽

Polymerase Chain ◽

Histopathology Examination

Laryngeal leishmaniasis is an unusual form of the disease. We report the case of a patient who consulted for dysphonia and dysphagia in a context of asthenia and weight loss. The patient had lesions that were suggestive of laryngeal cancer but were revealed to be leishmaniasis by histopathology examination and polymerase chain reaction. Treatment with amphotericin B and miltefosine permitted complete resolution of the lesions and no recurrence during the 18-month follow-up period.

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A Traumatic Tick Bite: A Case Report

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2021.3.50514 ◽

2021 ◽

Vol 2 (5) ◽

pp. 210-213

Author(s):

Daniel Finnin ◽

Christopher Hanowitz

Keyword(s):

Case Report ◽

Symptomatic Improvement ◽

Tick Bite ◽

Facial Trauma ◽

Laboratory Findings ◽

Human Granulocytic Anaplasmosis ◽

Presenting Symptoms ◽

Granulocytic Anaplasmosis ◽

Prophylactic Dose ◽

Tick Borne Disease

Introduction: Human granulocytic anaplasmosis is a tick-borne disease with an increasing incidence associated with morbidity and mortality. Uncertainty remains whether a prophylactic dose of doxycycline is effective in prevention. Case Report: We present a case of an 80-year-old female with syncope, resultant facial trauma, and fever two weeks after a tick bite for which she received prophylaxis. Workup revealed anaplasmosis, and treatment led to symptomatic improvement. Conclusion: We review the presenting symptoms, laboratory findings, and treatment of anaplasmosis, as well as give caution about the limitations in prescribing a prophylactic dose of doxycycline following a tick bite.

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