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Etiology of tick-borne febrile illnesses in adult residents of North-Eastern Poland: report from a prospective clinical study.
Int J Med Microbiol. 2006 May; 296 Suppl 40:242-9.IJ

Abstract

Febrile tick-borne diseases can be caused by different pathogens. The study objective was to prospectively determine the etiology of infection among adults exposed to tick bite and to detect acute human granulocytic anaplasmosis (HGA), a recently emerging infection, in north-eastern Poland. We evaluated 68 patients (34 males and 34 females, mean age 44.2+/-15 years) who had fever within 4 weeks after a tick bite. Paired sera were tested for antibodies against tick-borne encephalitis virus, Borrelia burgdorferi and Anaplasma phagocytophilum. Microscopic examination of EDTA whole blood and nested PCR targeting A. phagocytophilum 16S rDNA gene fragment were carried out at enrolment. Tick-borne infections were diagnosed in 57 individuals (84%). Sixty-four patients were hospitalised. Tick-borne encephalitis (TBE) was revealed in 49 cases; in 39 patients as a single infection, in three patients concurrent with erythema migrans or other Lyme borreliosis symptoms, in five patients concurrent with probable or possible Lyme borreliosis, and in two patients concurrent with A. phagocytophilum infection. Diagnosis of HGA was confirmed in one patient by PCR and in another one by seroconversion. In two further individuals, A. phagocytophilum infection was confirmed by immunofluorescence (antibody titers > or = 1:128), which, however, does not fulfil the ESCAR (European Society of Clinical Microbiology and Infectious Diseases Study Group on Coxiella, Anaplasma, Rickettsia, and Bartonella) criteria for HGA case definition. Lyme borreliosis was diagnosed in 16 patients; in six of them as a single infection. Both confirmed HGA cases and seropositive individuals had A. phagocytophilum infection concurrent either with Lyme borreliosis (two cases) or with TBE (two cases). The clinical course was severe in three and moderate to mild in the remaining TBE cases, as well as in all Lyme borreliosis and HGA cases. TBE was found the most prevalent disease among adults with febrile illnesses occurring after a tick bite in north-eastern Poland. Concurrent tick-borne infections were frequent with multiple pathogens involved. Two confirmed acute HGA cases (fulfilling the European case definition criteria defined by ESCAR) were detected for the first time in a prospective manner in Poland.

Authors+Show Affiliations

Department of Infectious Diseases, Medical University of Białystok, Zurawia 14 St., PL-15-540 Białystok, Poland. oliwa@amb.edu.plNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16530481

Citation

Grzeszczuk, Anna, et al. "Etiology of Tick-borne Febrile Illnesses in Adult Residents of North-Eastern Poland: Report From a Prospective Clinical Study." International Journal of Medical Microbiology : IJMM, vol. 296 Suppl 40, 2006, pp. 242-9.
Grzeszczuk A, Ziarko S, Kovalchuk O, et al. Etiology of tick-borne febrile illnesses in adult residents of North-Eastern Poland: report from a prospective clinical study. Int J Med Microbiol. 2006;296 Suppl 40:242-9.
Grzeszczuk, A., Ziarko, S., Kovalchuk, O., & Stańczak, J. (2006). Etiology of tick-borne febrile illnesses in adult residents of North-Eastern Poland: report from a prospective clinical study. International Journal of Medical Microbiology : IJMM, 296 Suppl 40, 242-9.
Grzeszczuk A, et al. Etiology of Tick-borne Febrile Illnesses in Adult Residents of North-Eastern Poland: Report From a Prospective Clinical Study. Int J Med Microbiol. 2006;296 Suppl 40:242-9. PubMed PMID: 16530481.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Etiology of tick-borne febrile illnesses in adult residents of North-Eastern Poland: report from a prospective clinical study. AU - Grzeszczuk,Anna, AU - Ziarko,Sławomir, AU - Kovalchuk,Oksana, AU - Stańczak,Joanna, Y1 - 2006/03/10/ PY - 2006/3/15/pubmed PY - 2006/9/19/medline PY - 2006/3/15/entrez SP - 242 EP - 9 JF - International journal of medical microbiology : IJMM JO - Int J Med Microbiol VL - 296 Suppl 40 N2 - Febrile tick-borne diseases can be caused by different pathogens. The study objective was to prospectively determine the etiology of infection among adults exposed to tick bite and to detect acute human granulocytic anaplasmosis (HGA), a recently emerging infection, in north-eastern Poland. We evaluated 68 patients (34 males and 34 females, mean age 44.2+/-15 years) who had fever within 4 weeks after a tick bite. Paired sera were tested for antibodies against tick-borne encephalitis virus, Borrelia burgdorferi and Anaplasma phagocytophilum. Microscopic examination of EDTA whole blood and nested PCR targeting A. phagocytophilum 16S rDNA gene fragment were carried out at enrolment. Tick-borne infections were diagnosed in 57 individuals (84%). Sixty-four patients were hospitalised. Tick-borne encephalitis (TBE) was revealed in 49 cases; in 39 patients as a single infection, in three patients concurrent with erythema migrans or other Lyme borreliosis symptoms, in five patients concurrent with probable or possible Lyme borreliosis, and in two patients concurrent with A. phagocytophilum infection. Diagnosis of HGA was confirmed in one patient by PCR and in another one by seroconversion. In two further individuals, A. phagocytophilum infection was confirmed by immunofluorescence (antibody titers > or = 1:128), which, however, does not fulfil the ESCAR (European Society of Clinical Microbiology and Infectious Diseases Study Group on Coxiella, Anaplasma, Rickettsia, and Bartonella) criteria for HGA case definition. Lyme borreliosis was diagnosed in 16 patients; in six of them as a single infection. Both confirmed HGA cases and seropositive individuals had A. phagocytophilum infection concurrent either with Lyme borreliosis (two cases) or with TBE (two cases). The clinical course was severe in three and moderate to mild in the remaining TBE cases, as well as in all Lyme borreliosis and HGA cases. TBE was found the most prevalent disease among adults with febrile illnesses occurring after a tick bite in north-eastern Poland. Concurrent tick-borne infections were frequent with multiple pathogens involved. Two confirmed acute HGA cases (fulfilling the European case definition criteria defined by ESCAR) were detected for the first time in a prospective manner in Poland. SN - 1438-4221 UR - https://www.unboundmedicine.com/medline/citation/16530481/Etiology_of_tick_borne_febrile_illnesses_in_adult_residents_of_North_Eastern_Poland:_report_from_a_prospective_clinical_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1438-4221(06)00008-7 DB - PRIME DP - Unbound Medicine ER -