First documented case of human granulocytic ehrlichiosis in Austria

We report the first documented case of human granulocytic ehrlichiosis (HGE) in Austria. The infection was acquired near Arzl in the surroundings of Innsbruck in northern Tyrol. Except for a biphasic course of illness, presentation in this 33-year-old female patient was comparable to clinical findin...

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Bibliographic Details
Published in:Wiener Klinische Wochenschrift 2003-04, Vol.115 (7-8), p.263-266
Main Authors: Walder, Gernot, Falkensammer, Barbara, Aigner, Johannes, Tiwald, Gerhard, Dierich, Manfred P, Würzner, Reinhard, Lechleitner, Peter
Format: Article
Language:English
Subjects:
Adult
Anaplasma phagocytophilum - immunology
Antibodies, Bacterial - blood
Austria
Diagnosis, Differential
Doxycycline - therapeutic use
Ehrlichiosis - diagnosis
Ehrlichiosis - drug therapy
Ehrlichiosis - immunology
Female
Fluorescent Antibody Technique, Direct
Follow-Up Studies
Humans
Immunoglobulin G - blood
Platelet Count
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Summary:We report the first documented case of human granulocytic ehrlichiosis (HGE) in Austria. The infection was acquired near Arzl in the surroundings of Innsbruck in northern Tyrol. Except for a biphasic course of illness, presentation in this 33-year-old female patient was comparable to clinical findings observed in other European adults with high fever, transient thrombocytopenia, elevated levels of CRP and LDH, arthralgias, myalgias, fatigue and subfebrile temperature. Flu-like symptoms started about seven days after a tick bite and lasted for ten days, followed by an asymptomatic interval of three days and an acute onset of fever up to 39.5 degrees C on day 20. On admission, the patient showed high antibody titres against Anaplasma phagocytophilum (IgG 1:1024, IgM 1:640); six weeks later the IgG-titre had risen to 1:2048, and IgM-levels had fallen below 1:40. The demonstration of anti-platelet antibodies in acute-phase serum was noteworthy. We conclude that also in Austria HGE should be considered in patients with febrile thrombocytopenia, especially when the medical history reveals recent tick exposure.
ISSN:0043-5325
1613-7671
DOI:10.1007/BF03040326