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

Abstract

Human granulocytic anaplasmosis (HGA) is a tick-borne infectious disease caused by , an obligate intracellular bacterium. Until now, the utility of tick-bite site samples for HGA diagnosis has not been reported. Using a patient's buffy coat and tick-bite site crust samples, we performed polymerase chain reaction (PCR) testing using- or -specific primers. PCR with buffy coat and crust samples obtained before doxycycline administration was positive. Six days after doxycycline administration, PCR with the buffy coat sample was negative but PCR with a crust tissue sample from the tick-bite site remained positive. This is the first case to suggest that crust tissue at the tick-bite site may be useful for early HGA diagnosis in patients who have already been treated with antibiotics such as doxycycline.

Profiles of Kelch mutations in Plasmodium falciparum across South Asia and their implications for tracking drug resistance

“…ART resistance in the absence of K13 mutations has been reported (Table 3) (Ariey et al, 2014; Cerqueira et al, 2017; Davis et al, 2017; Demas et al, 2018; Lee and Fidock, 2016; Miotto et al, 2015; Mukherjee et al, 2017; Sá et al, 2018; Takala-Harrison et al, 2013, 2015; Wang et al, 2016). Identification of four parasite isolates from Cambodia with wild type K13 protein but RSA ≥0.8% had suggested K13-independent ART resistance (Mukherjee et al, 2017).…”

Asymptomatic-anaplasmosis confirmation using genetic and serological tests and possible coinfection with spotted fever group Rickettsia: a case report

“…Unlike Borrelia burgdorferi, A. phagocytophilum and SFG Rickettsia get inoculated into a host within 2 to 6 h of attachment following a tick bite [16]. The serological diagnosis of an A. phagocytophilum infection can be confirmed when there is a four-fold increase in the antibody titer in convalescent-phase serum compared to that in acute-phase serum [17,18]. Because the increase in the plasma concentration of antibodies in response to A. phagocytophilum proceeds slowly, a significant increase is not detectable in the acute phase.…”

Manifestation of anaplasmosis as cerebral infarction: a case report

“…A blood sample was tested using nested PCR with Anaplasma and Ehrlichia- specific primers targeting the GroEL heat-shock protein gene ( groEL ) and ankyrin-repeat protein AnkA gene ( ankA ), Additionally, a portion of the 16S ribosomal RNA gene (16S rRNA) was amplified using PCR [ 6 – 8 ]. The PCR amplicons were purified and directly sequenced using PCR primers.…”

“…Immunofluorescence assay (IFA) antibodies against A. phagocytophilum were also measured from the blood sample [ 8 ]. Upon admission, the immunoglobulin (Ig) M level was below 1:16 and the IgG level was below 1:80.…”