TY - JOUR T1 - Infections with the tick-borne bacterium "Candidatus Neoehrlichia mikurensis" mimic noninfectious conditions in patients with B cell malignancies or autoimmune diseases. AU - Grankvist,Anna, AU - Andersson,Per-Ola, AU - Mattsson,Mattias, AU - Sender,Monica, AU - Vaht,Krista, AU - Höper,Linnea, AU - Sakiniene,Egidija, AU - Trysberg,Estelle, AU - Stenson,Martin, AU - Fehr,Jan, AU - Pekova,Sona, AU - Bogdan,Christian, AU - Bloemberg,Guido, AU - Wennerås,Christine, Y1 - 2014/03/18/ PY - 2014/3/21/entrez PY - 2014/3/22/pubmed PY - 2015/2/14/medline KW - B-cell malignancies KW - human KW - infection, Neoehrlichia KW - tick-borne SP - 1716 EP - 22 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 58 IS - 12 N2 - BACKGROUND: Candidatus Neoehrlichia mikurensis is a newly discovered noncultivatable bacterium spread among ticks and rodents in Europe and Asia that can infect humans, particularly immunocompromised patients. METHODS: We compiled clinical and laboratory data from 11 patients with hematological malignances or autoimmune diseases who were diagnosed with Candidatus N. mikurensis infection in Europe 2010-2013. Both published (6) and unpublished cases (5) were included. RESULTS: The patients had a median age of 67, were mostly male (8/11), and resided in Sweden, Switzerland, Germany, and the Czech Republic. All but one had ongoing or recent immune suppressive treatment and a majority were splenectomized (8/11). Less than half of them recalled tick exposure. The most frequent symptoms were fever (11/11), localized pain afflicting muscles and/or joints (8/11), vascular and thromboembolic events (6/11), that is, deep vein thrombosis (4), transitory ischemic attacks (2), pulmonary embolism (1), and arterial aneurysm (1). Typical laboratory findings were elevated C-reactive protein, leukocytosis with neutrophilia, and anemia. Median time from onset of symptoms to correct diagnosis was 2 months. In at least 4 cases, the condition was interpreted to be due to the underlying disease, and immunosuppressive therapy was scheduled. All patients recovered completely when doxycycline was administered. CONCLUSIONS: Candidatus N. mikurensis is an emerging tick-borne pathogen that may give rise to a systemic inflammatory syndrome in persons with hematologic or autoimmune diseases that could be mistaken for recurrence of the underlying disease and/or unrelated arteriosclerotic vascular events. Awareness of this new pathogen is warranted among rheumatologists, hematologists, oncologists, and infectious disease specialists. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/24647019/Infections_with_the_tick_borne_bacterium_"Candidatus_Neoehrlichia_mikurensis"_mimic_noninfectious_conditions_in_patients_with_B_cell_malignancies_or_autoimmune_diseases_ DB - PRIME DP - Unbound Medicine ER -