| Clinical findings and diagnosis in human granulocytic anaplasmosis: a case series from Massachusetts. | |
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MedLine Citation:
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PMID: 22386178 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To describe clinical findings and the use of a tick-associated pathogen panel in a series of patients with human granulocytic anaplasmosis (HGA) at a suburban Boston hospital. PATIENTS AND METHODS: Medical records were reviewed for inpatients and outpatients at Newton-Wellesley Hospital with a positive polymerase chain reaction (PCR) result for Anaplasma phagocytophilum during the study period March 1 through November 30, 2009. A PCR panel was used to test for tick-borne pathogens. Postal ZIP code data from the patients' areas of residence were used to estimate the area of disease transmission. RESULTS: Thirty-three cases were confirmed during the 2009 transmission season, and 14 of these patients (42%) required hospitalization. Thrombocytopenia and/or leukopenia were observed at the time of presentation in 25 of 30 patients (86%) in whom both white blood cell and platelet counts were determined, and 28 of 33 patients (85%) reported fever. Rash occurred in only 2 of the 33 patients (6%), and 25 (76%) reported one or more respiratory or gastrointestinal symptom. Cases were geographically distributed diffusely throughout the hospital catchment area, with one possible focus of infection identified in Weston, MA. Due to a lack of clinical data reporting to the Massachusetts Department of Public Health, only 20 of 32 HGA cases (63%) fulfilled the case confirmation criteria. CONCLUSION: Diagnosis of HGA requires a high suspicion for infection even in endemic areas. Use of a tick-associated pathogen panel that includes PCR assays for several organisms could improve detection of underrecognized tick-borne diseases in endemic areas. Lack of epidemiological follow-up to confirm corroborating clinical findings prevents accurate case reporting and assessment of the true HGA burden. |
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Authors:
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Ana A Weil; Elinor L Baron; Catherine M Brown; Mark S Drapkin |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 87 ISSN: 1942-5546 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-03-05 Completed Date: 2012-04-25 Revised Date: 2013-03-13 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: England |
Other Details:
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Languages: eng Pagination: 233-9 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine, Massachusetts General Hospital, 15 Parkman St., Boston, MA 02114, USA. aweil@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Anaplasma phagocytophilum* Anaplasmosis / complications, diagnosis*, epidemiology, pathology, transmission Animals Exanthema / etiology, microbiology Female Humans Leukopenia / etiology, microbiology Male Massachusetts / epidemiology Middle Aged Polymerase Chain Reaction Thrombocytopenia / etiology, microbiology Ticks / microbiology Young Adult |
| Comments/Corrections | |
Erratum In:
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Mayo Clin Proc. 2012 Jun;87(6):606 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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