Neoehrlichia mikurensis is uncommon in rheumatological patients receiving tumour necrosis factor inhibitors and in blood donors: a retrospective cohort study.

INTRODUCTION: Neoehrlichia mikurensis is a tick-borne bacterium that primarily causes disease in immunocompromised patients. The bacterium has been detected in ticks throughout Europe, with a 0%-25% prevalence. N. mikurensis infection presents unspecific symptoms, which can easily be mistaken for inflammatory disease activity. We aimed to determine the prevalence of N. mikurensis in rheumatological patients receiving tumour necrosis factor inhibitors (TNFi) and a cohort of healthy individuals. MATERIALS AND METHODS: This retrospective cohort study included 400 rheumatological patients treated with TNFi and 400 healthy blood donors. Plasma samples were retrieved from the Danish Rheumatological Biobank and the Danish Blood Donor Study between 2015 and 2022. Age, sex, diagnosis and duration of TNFi treatment were recovered from the Danish Rheumatological Database, DANBIO. Data on age and sex were available for the blood donors. One plasma sample per individual was tested for N. mikurensis DNA-specific real-time PCR targeting the groEL gene. RESULTS: In the rheumatological patients, the median age was 61 years (IQR 55-68 years), 62% were women, and 44% had a diagnosis of seropositive rheumatoid arthritis. In total, 54% of the patients were treated with infliximab. The median time from TNFi initiation to blood sampling was 20 months (IQR, 5-60 months). N. mikurensis DNA was not detected in any samples from patients or blood donors. CONCLUSION: N. mikurensis infection does not appear to represent a prevalent risk in Danish rheumatological patients receiving TNFi or in blood donors.

Candidatus Neoehrlichia mikurensis Infection in Patient with Antecedent Hematologic Neoplasm, Spain1.

We report a confirmed case of Candidatus Neoehrlichia mikurensis infection in a woman in Spain who had a previous hematologic malignancy. Candidatus N. mikurensis infections should be especially suspected in immunocompromised patients who exhibit persistent fever and venous thrombosis, particularly if they live in environments where ticks are prevalent.

Molecular pathogen screening of louse flies (Diptera: Hippoboscidae) from domestic and wild ruminants in Austria.

BACKGROUND: Hippoboscid flies (Diptera: Hippoboscidae), also known as louse flies or keds, are obligate blood-sucking ectoparasites of animals, and accidentally of humans. The potential role of hippoboscids as vectors of human and veterinary pathogens is being increasingly investigated, but the presence and distribution of infectious agents in louse flies is still unknown in parts of Europe. Here, we report the use of molecular genetics to detect and characterize vector-borne pathogens in hippoboscid flies infesting domestic and wild animals in Austria. METHODS: Louse flies were collected from naturally infested cattle (n = 25), sheep (n = 3), and red deer (n = 12) across Austria between 2015 and 2019. Individual insects were morphologically identified to species level and subjected to DNA extraction for molecular pathogen screening and barcoding. Genomic DNA from each louse fly was screened for Borrelia spp., Bartonella spp., Trypanosomatida, Anaplasmataceae, Filarioidea and Piroplasmida. Obtained sequences of Trypanosomatida and Bartonella spp. were further characterized by phylogenetic and haplotype networking analyses. RESULTS: A total of 282 hippoboscid flies corresponding to three species were identified: Hippobosca equina (n = 62) collected from cattle, Melophagus ovinus (n = 100) from sheep and Lipoptena cervi (n = 120) from red deer (Cervus elaphus). Molecular screening revealed pathogen DNA in 54.3% of hippoboscids, including infections with single (63.39%), two (30.71%) and up to three (5.90%) distinct pathogens in the same individual. Bartonella DNA was detected in 36.9% of the louse flies. Lipoptena cervi were infected with 10 distinct and previously unreported Bartonella sp. haplotypes, some closely associated with strains of zoonotic potential. DNA of trypanosomatids was identified in 34% of hippoboscids, including the first description of Trypanosoma sp. in H. equina. Anaplasmataceae DNA (Wolbachia spp.) was detected only in M. ovinus (16%), while < 1% of the louse flies were positive for Borrelia spp. and Filarioidea. All hippoboscids were negative for Piroplasmida. CONCLUSIONS: Molecular genetic screening confirmed the presence of several pathogens in hippoboscids infesting domestic and wild ruminants in Austria, including novel pathogen haplotypes of zoonotic potential (e.g. Bartonella spp.) and the first report of Trypanosoma sp. in H. equina, suggesting a potential role of this louse fly as vector of animal trypanosomatids. Experimental transmission studies and expanded monitoring of hippoboscid flies and hippoboscid-associated pathogens are warranted to clarify the competence of these ectoparasites as vectors of infectious agents in a One-Health context.

Cytokine responses of immunosuppressed and immunocompetent patients with Neoehrlichia mikurensis infection.

PURPOSE: The tick-borne bacterium Neoehrlichia mikurensis causes the infectious disease neoehrlichiosis in humans. Vascular endothelium is one of the target cells of the infection. Neoehrlichiosis patients with compromised B cell immunity present with more severe inflammation than immunocompetent patients. The aim of this study was to compare the cytokine profiles of immunocompetent and immunosuppressed patients with neoehrlichiosis. METHODS: Blood samples from Swedish and Norwegian immunosuppressed (N = 30) and immunocompetent (N = 16) patients with neoehrlichiosis were analyzed for the levels of 30 cytokines, using a multiplex cytokine assay and ELISA. A gender-matched healthy control group (N = 14) was analyzed in parallel. Data were analyzed using the multivariate method OPLS-DA. RESULTS: The multiplex cytokine analyses generated more cytokine results than did the uniplex ELISA analyses. Multivariate analysis of the multiplex cytokine results established that increased levels of FGF2, GM-CSF, CXCL10, and IFN-γ were associated with immunosuppressed patients, whereas increased levels of IL-15 and VEGF were associated with immunocompetent neoehrlichiosis patients. When multivariate analysis findings were confirmed with uniplex ELISA, it was found that both groups of patients had similarly elevated levels of VEGF, FGF2 and IFN-γ. In contrast, the immunosuppressed patients had clearly elevated levels of CXCL10, CXCL13 and BAFF, whereas the immunocompetent patients had the same levels as healthy controls. CONCLUSION: Pro-angiogenic and type 1 cytokines were produced as part of the host response of neoehrlichiosis independent of immune status, whereas immunosuppressed neoehrlichiosis patients produced cytokines required for B cell-mediated defense.

[Neoehrlichiosis as a cause of feaver of unknown origin]. / Neoehrlichiose als Ursache eines Fiebers unklarer Genese.

Establishing a diagnosis in cases of fever of unknown origin (FUO) in immunocompromised patients can be difficult. In 25-35% infectious diseases are the underlying cause. This article reports the case of a 74-year-old woman with a 5-month history of fever. Through open biopsy of the femoral shaft and microbiological analysis, a diagnosis of neoehrlichiosis could be established. After initiation of treatment with doxycycline, the symptoms quickly resolved resulting in a complete recovery.

Molecular detection of anaplasmataceae agents on dogs from the departament of Piura, Peru

This study aimed to study the prevalence of Anaplasmataceae organisms through the nested-PCR and phylogenetic analysis on domestic dogs in the Department of Piura, Peru. Two hundred and twelve canine blood samples were randomly collected on dogs from the central urban areas at the Piura Department in Peru. The extracted DNAs were tested, by nested-PCR based on 16SrRNA gene, to identify agents from Anaplasmataceae family. These results show that there was a prevalence of 18.5% (40/216) of positive dogs, 13.8% (30/216) for Ehrlichia canis, 7.4% (16/216) for Anaplasma platys and 0.1% (2/216) for Ehrlichia sp. confirmed by sequencing analysis. Co-positivity among Anaplasmataceae family species was present in 25% (10/40) of positive samples. There was a significant association among Anaplasmataceae family infection in dogs and the following variables: sex (p=0.034), presence of ticks (p=0.0001), and socio-economic status (p=0.001). There was no statistical association on the variables "living with other animals" and "age group" (p=0.1074). The partial sequences on the portion of the 16S rRNA gene, from positive samples for agents of Anaplasmataceae family demonstrated an identity of 97-100% with the isolated E. canis and A. platys obtained from the GenBank. This is the first study on infection by agents of Anaplasmataceae family in dogs in the Department of Piura, through molecular analysis

An immunosuppressed woman in her seventies with night sweats and weight loss. / En immunsupprimert kvinne i 70-årene med nattesvette og vekttap.

BACKGROUND: Candidatus Neoehrlichia mikurensis is an emerging tick-borne pathogen with widespread distribution in Ixodes ricinus ticks in Europe and Asia. It has been found to cause chronic infections, particularly in immunosuppressed individuals. Common symptoms include relapsing fever, night sweats and thromboembolic episodes, likely due to endovascular infection. CASE PRESENTATION: A patient in her seventies developed persistent night sweats and moderate weight loss that persisted for four months prior to evaluation. There was no history of fever or organ-specific symptoms. Prior diseases included a ten-year history of rheumatoid arthritis treated with rituximab. Initial workup revealed moderately increased acute phase reactants, but no evidence of malignant disease or endocrine abnormalities. Night sweats persisted, and after eight months moderate splenic enlargement was observed. PCR revealed presence of Candidatus Neoehrlichia mikurensis DNA, and symptoms resolved promptly after initiation of oral doxycycline treatment. INTERPRETATION: Infection with anaplasmataceae such as Candidatus Neoehrlichia mikurensis can present with non-specific constitutive symptoms. In this case, persistent night sweats and moderate weight loss were the only manifestations over an eight-month period. Diagnosis is readily established by PCR analysis of whole blood, but a high degree of suspicion and careful assessment of potential exposure is required for timely diagnosis.

The emerging tick-borne pathogen Neoehrlichia mikurensis: first French case series and vector epidemiology.

Neoehrlichia mikurensis is an intracellular bacterium transmitted in Europe and Asia by ticks of the Ixodes ricinus complex. Interest in this bacterium has increased since it was demonstrated to be responsible for febrile syndromes in patients. To date, most clinical cases have been reported in northern Europe, but case series have also been described in central Europe and China. Notably, thrombotic events occurred during the course of the disease. We investigated the presence of N. mikurensis in 10,885 I. ricinus nymphs in two regions of France (Alsace and Brittany) collected between 2013 and 2020 and in 934 patients suspected of human granulocytic anaplasmosis in Alsace, an endemic area for Lyme borreliosis, using a specific PCR assay. N. mikurensis was detected in 5.42% of the ticks from Alsace, whereas only one (0.03%) tick was found to be positive in Brittany. Spatiotemporal disparities were also noticed within the Alsace region over the four collection sites investigated, and a significant increase in the prevalence of nymphs carrying N. mikurensis was also observed in the last three years of collection. Four out of 934 screened patients were found to be positive for N. mikurensis. Two had malignancies, and the other two were apparently immunocompetent. Superficial thrombosis was noticed in one patient, and long-lasting bacteremia was noted in another patient. These four patients are the first clinical cases of neoehrlichiosis described in France. We suggest including N. mikurensis in the differential diagnosis of post-tick bite febrile syndromes to treat patients and prevent the occurrence of thrombotic complications.

[Tick-borne CandidatusNeoehrlichiamikurensis was the cause of fever in a haematological patient].

A 77-year-old woman had a history of mantle cell lymphoma, splenechtomy and rituximab-treatment. For six months she had fever, night sweats and weight loss. Thorough investigations did not reveal the cause of the fever, and empiric antibiotics had no effect. Eventually she developed an erythema nodosum-like rash on both legs. A biopsy was sent for 16S rRNA PCR, which was positive for Candidatus Neoehrlichia mikurensis. She was treated with doxycycline with resolution of all symptoms. This is the first case report of neoehrlichiosis in Denmark, and the first case diagnosed on a skin biopsy.

Molecular survey of tick-borne pathogens in small mammals from Brazilian Amazonia / Levantamento molecular de patógenos transmitidos por carrapatos em pequenos mamíferos da Amazônia brasileira

Abstract Small non-volant mammals (marsupials and small rodents) were captured at three different timepoints from 23 forest fragments across three municipalities (Alta Floresta, Sinop and Cláudia) covering the Amazonian biome of the Mato Grosso State in Midwestern Brazil. The animal tissues (liver and spleen) and blood were screened using molecular tools for the detection of Babesia, Coxiella, Cytauxzoon, Hepatozoon, Theileria, and Anaplasmataceae agents. A total of 230 specimens (78 rodents and 152 marsupials) were trapped. Hepatozoon and Piroplasmorida agents were detected in the common opossums (Didelphis marsupialis). In turn, all samples (blood, liver, or spleen) collected from the small mammals were negative for the genus Coxiella and the family Anaplasmataceae, as detected by polymerase chain reaction (PCR). Phylogenetic analyses inferred from partial sequences of the 18S rRNA gene highlighted the occurrence of new Hepatozoon and Piroplasmorida haplotypes. Future studies determining the role of common opossum (D. marsupialis) in the epidemiological cycles of Hepatozoon and Babesia under natural conditions in the Amazonian biome are necessary.

Resumo Pequenos mamíferos não voadores (marsupiais e pequenos roedores) foram capturados em três diferentes períodos, ao longo de 23 fragmentos florestais de três municípios (Alta Floresta, Sinop e Cláudia), localizados no bioma amazônico do Estado de Mato Grosso, no centro-oeste do Brasil. Os tecidos dos animais (fígado e baço) e sangue foram selecionados e submetidos a ensaios moleculares para a detecção do DNA de Babesia, Coxiella, Cytauxzoon, Hepatozoon, Theileria e agentes Anaplasmataceae. Um total de 230 espécimes (78 roedores e 152 marsupiais) foram capturados. Hepatozoon e agentes Piroplasmorida foram detectados em gambás (Didelphis marsupialis). Ao contrário, todas as amostras (sangue, fígado ou baço) coletadas dos pequenos mamíferos foram negativas para o gênero Coxiella e a família Anaplasmataceae, conforme detectado pela reação em cadeia da polimerase (PCR). Análises filogenéticas inferidas pelas sequências parciais do gene 18S rRNA evidenciaram a ocorrência de novos haplótipos de Hepatozoon e Piroplasmorida. Futuros estudos determinando a importância do gambá-comun (D. marsupialis) nos ciclos epidemiológicos de Hepatozoon e Babesia em condições naturais, no bioma amazônico, são necessários.

Ehrlichiosis monocítica humana y babesiosis en Venezuela / Human monocytic ehrlichiosis and babesiosis in Venezuela

Resumen La babesiosis o "Fiebre de garrapatas" es una enfermedad febril y anemizante, producida en animales domésticos y salvajes y ocasionalmente en humanos por especies del genero Babesia, las cuales son protozoarios intraeritrocíticos. Se denomina ehrlichiosis y anaplasmosis a un grupo de infecciones bacterianas transmitidas por garrapatas duras (Ixodidae), que afectan al ser humano y a los animales. Son de distribución universal, y están relacionadas con varias especies de los géneros Anaplasma y Ehrlichia (familia Anaplasmataceae). La fiebre de origen desconocido en pacientes con historia de viajes a zonas endémicas de Ixodes resulta con alto índice de sospecha para la búsqueda de infecciones por Babesia, Borrelia y Ehrliquia, ya que pueden ocurrir simultáneamente, particularmente con estos dos últimos géneros. Se reporta un caso de paciente femenina de 49 años de edad, procedente de Tumeremo estado Bolívar, ocupación minera, quien consultó por fiebre con escalofríos, cefalea y mialgias predominantes en miembros inferiores. Ingresó a Terapia intensiva por cuadro de distres respiratorio y shock séptico. Se descartó malaria por gota gruesa seriada negativas, el hemocultivo y urocultivo reportaron ausencia de crecimiento bacteriano. Se realizó frotis de capa blanca siendo positiva para Ehrliquia monocítica y Babesia bigemina. La paciente evolucionó satisfactoriamente luego del tratamiento con Doxiciclina, clindamicina más meropenem. El fin de este reporte es concientizar a la comunidad médica de la existencia de la ehrlichiosis como entidad clínica emergente en nuestro país y la posibilidad de coexistir con otros microorganismos que comparten el mismo vector, con el fin de considerar tratamiento empírico oportuno en pacientes con factores de riesgo en las zonas rurales.

Abstract Babesiosis or "Tick fever" is a feverish and anemic disease, produced in domestic and wild animals and occasionally in humans by species of the genus Babesia, which are intra-erythrocytic protozoans. Ehrlichiosis and anaplasmosis are called a group of bacterial infections transmitted by hard ticks (Ixodidae), which affect humans and animals. They are of universal distribution, and are related to several species of the genera Anaplasma and Ehrlichia (family Anaplasmataceae). Fever of unknown origin in patients with a history of travel to endemic areas of Ixodes results in a high index of suspicion for the search for Babesia, Borrelia and Ehrliquia infections, since they can occur simultaneously, particularly with these last two genera. We report a case of female patient, 49 years old, from Tumeremo Bolívar state, mining occupation, who consulted for fever with chills, headache and myalgias predominant in lower limbs. He entered intensive therapy for respiratory distress and septic shock. Malaria was ruled out by gross negative strains, blood culture and urine culture showed no bacterial growth. White-coat smears were positive for monocytic Ehrliquia and Babesia bigemina. The patient progressed satisfactorily after treatment with Doxycycline, clindamycin plus meropenem. The purpose of this report is to make the medical community aware of the existence of ehrlichiosis as an emerging clinical entity in our country and the possibility of coexisting with other microorganisms that share the same vector in order to consider timely empirical treatment in patients with factors risk in rural areas.

Anaplasmataceae em gatos (Felis catus) no município de Campos dos Goytacazes, Rio de Janeiro / Anaplasmataceae in cats (Felis catus) in the city of Campos dos Goytacazes, Rio de Janeiro

No Brasil, até o ano 2000, os agentes riquetsiais em felinos domésticos eram poucos conhecidos, existindo somente relatos esporádicos de Ehrlichia sp. As recentes pesquisas envolvendo biologia molecular e agentes riquetsiais confirmam a ideia de que estes agentes estão presentes nesses animais e, por este motivo, demonstram a necessidade de estudos mais detalhados no Brasil. O objetivo do presente trabalho foi a caracterização dos agentes da família Anaplasmataceae que acometem os felinos domésticos e esclarecer a importância dos felinos na cadeia epidemiológica das doenças riquetsiais por métodos moleculares e sorológicos associando a presença das doenças aos parâmetros clínicos e laboratoriais. Foram obtidas amostras sanguíneas de 60 felinos domésticos, independentes de sanidade, provenientes de atendimentos clínicos. Destas amostras foram realizados hemograma e bioquímica sérica, e os dados foram utilizados para preenchimento da ficha laboratorial. As amostras foram processadas para obtenção de concentração de células e soro, para realização da reação em cadeia pela polimerase (PCR) e reação por imunofluorescência indireta (RIFI), respectivamente, para identificação de agentes da família Anaplasmataceae. Os dados foram utilizados para análise descritiva para formação de frequências epidemiológicas e para realização de testes não-paramétricos pelo Qui-quadrado de Pearson (p≤5%) associando as alterações laboratoriais às infecções por Ehrlichia canis, Anaplasma platys e Anaplasma phagocytophilum. Os resultados obtidos revelaram a presença de 33,33% de agentes Anaplamastaceae na amostra populacional, sendo 8,33% para E. canis, 20% para A. platys e 10% para A. phagocytophilum. Foram realizadas as sorologias das amostras, pela imunofluorescência indireta, para verificação de amostras reagentes para A. phagocytophilum, sendo 8,33% amostras reagentes na amostra populacional. As alterações clínicas e laboratoriais mais frequentes em pacientes positivos por agentes Anaplasmataceae foram letargia, linfadenomegalia, mucosas pálidas, desidratação, trombocitopenia, hiperglobulinemia e hipoalbuminemia. Destes dados foram realizadas as correlações não paramétricas e não foram verificadas dependências das alterações laboratoriais com a presença de animais positivos para agentes Anaplasmataceae. A identificação dos agentes E. canis e A. platys visa esclarecer a doença na região, sendo instrumento de orientação da doença pelo médico veterinário ao proprietário para que tenha medidas adequadas de tratamento e prevenção. A presença de agentes A. phagocytophilum é considerada, sem dúvidas, uma notificação importante devido ao potencial zoonótico.(AU)

In Brazil, by the year 2000, rickettsioses in domestic cats were little known and there were only sporadic reports of Ehrlichia sp. Recent research involving molecular biology and rickettsioses confirm the notion of the presence of theses agents in cats and show the need for more studies in Brazil. The objective of this paper was to characterize agents belonging to the Anaplasmataceae family that affect domestic cats and to clarify the importance of cats in the epidemiology of rickettsioses by molecular and serological methods associating the presence of disease with clinical and laboratory parameters. Blood samples were obtained from 60 healthy domestic cats. Blood count and serum biochemical tests were performed, and the data were registered. The samples were processed to obtain cell concentration and serum to perform the polymerase chain reaction (PCR) and the indirect immunofluorescence assay (IFA) respectively, in order to identify agents of the Anaplasmataceae family. The data were used for descriptive analysis to obtain frequencies and to perform non-parametric tests with the chi-square test (p≤5%), besides the laboratory findings of infection by Ehrlichia canis, Anaplasma phagocytophilum and Anaplasma platys. The results revealed that 33.33% of the agents belonged to the Anaplasmataceae family, 8.33% for E. canis, 20% for A. platys, and 10% for A. phagocytophilum. Serology samples were examined by indirect immunofluorescence to check samples reacting to A. phagocytophilum, with positive reaction of 8.33%. The most frequent clinical and laboratory findings in patients positive for Anaplasmataceae agents were lethargy, enlargement of lymph nodes, pale mucous membranes, dehydration, thrombocytopenia, hyperglobulinemia and hypoalbuminemia. These data had non-parametric correlation and the laboratory changes and presence of positive cats was not interdependent. Identification of E. canis and A. platys revealed the disease in the region of Campos dos Goytacazes/RJ. The presence of A. phagocytophilum is considered an important finding due to its zoonotic potential.(AU)

[Fever of unknown origin in a multiple sclerosis patient on immunomodulatory therapy was due to neoehrlichiosis]. / Oklar feber hos patient med MS och rituximab­behandling var neoehrlichios - Ny fästingburen infektion som är svår att diagnostisera.

Fever of unknown origin in a multiple sclerosis patient on immunomodulatory therapy was due to neoehrlichiosis The emerging tick-borne bacterium Candidatus Neoehrlichia mikurensis is the etiologic agent of neoehrlichiosis, a febrile illness that may be accompanied by vascular complications. Severe cases of neoehrlichiosis have been described in patients with hematologic malignancies and systemic rheumatic diseases. We present the first case of neoehrlichiosis in a patient with multiple sclerosis undergoing rituximab therapy.

Molecular screening for Rickettsia, Anaplasmataceae and Coxiella burnetii in Rhipicephalus sanguineus ticks from Malaysia.

A total of 44 Rhipicephalus sanguineus ticks collected from 23 dogs from Malaysia were screened for Rickettsia, Anaplasmataceae and Coxiella burnetii. Coxiella burnetii was detected in 59% (26/44) of ticks however Rickettsia and Anaplasmataceae were not detected in any of the ticks. In order to genotype the strains of C. burnetii, multispacer sequence typing (MST) was carried out using three different spacers. One of the spacers; Cox2 successfully amplified a fragment for which the full length sequence of 397 bp was obtained. The sequenced product revealed only a single nucleotide difference with the Cox2.3 type sequence.

Candidatus Neoehrlichia mikurensis infection identified in 2 hematooncologic patients: benefit of molecular techniques for rare pathogen detection.

Hematooncologic patients often host rare or fastidious pathogens. Using 16S rDNA sequencing and transmission electron microscopy, we have identified 2 lymphoma patients infected with Candidatus Neoehrlichia mikurensis. In both individuals, the clinical presentation suggested ehrlichiosis-like syndrome. We believe that molecular techniques open new vistas in the field of pathogen detection.

Detection of "Candidatus Neoehrlichia mikurensis" in two patients with severe febrile illnesses: evidence for a European sequence variant.

Recently, a new genus of Anaplasmataceae termed "Candidatus Neoehrlichia" was discovered in ticks and rodents. Here, we report on two patients who suffered from febrile bacteremia due to "Candidatus Neoehrlichia mikurensis" associated with thrombotic or hemorrhagic events. 16S rRNA and groEL gene sequencing provided evidence of three groups of sequence variants.

Molecular detection of anaplasma platys in a naturally-infected cat in Brazil

Following the accidental finding of inclusion bodies similar to Anaplasma platys in a stained blood smear from a cat, DNA analysis of the 16S rRNA gene was performed and 100 percent identity was found with different strains of A. platys. These data confirm that cats are susceptible to parasitism by A. platys.

First case of human "Candidatus Neoehrlichia mikurensis" infection in a febrile patient with chronic lymphocytic leukemia.

An immunocompromised patient presented with febrile episodes, an erysipelas-like rash, and thromboembolic complications. Amplification of 16S rRNA gene sequences from blood and sequence analysis revealed "Candidatus Neoehrlichia mikurensis." We report the first case of human disease caused by "Ca. Neoehrlichia mikurensis."

Molecular diagnosis of Anaplasmataceae organisms in dogs with clinical and microscopical signs of ehrlichiosis / Diagnóstico molecular de agentes da família Anaplasmataceae em cães com sinais clínicos e microscópios de erliquiose

Ehrlichioses are important emerging zoonotic tick-borne diseases that can affect both animals and humans. Clinical manifestations of ehrlichiosis caused by different members of Anaplasmataceae in dogs are similar to each other and to other diseases showing systemic manifestation. The observation of inclusions in white blood cells and in platelets cannot be used to confirm the Anaplasmataceae etiologic agent of the disease. In this work we assessed the presence of Anaplasmataceae agents in 51 dogs from two different cities (Jaboticabal and Campo Grande) showing clinical and microscopical diagnosis of ehrlichiosis, by using molecular techniques. Anaplasmataceae DNA were amplified in 46/51 (90.2 percent) of the blood samples; 22 (40 percent) samples from Jaboticabal and 10 (18.2 percent) from Campo Grande were positive for E. canis nPCR. Anaplasma platys DNA was amplified in 2 samples from Jaboticabal and in 11 from Campo Grande. Phylogenetic analysis of E. canis and A. platys DNA confirmed the infection agent and showed that PCR is the most reliable method to diagnose ehrlichial infection.

Erliquioses são importantes enfermidades emergentes transmitidas por carrapatos que podem afetar os animais e o homem. Em cães, as manifestações clínicas da erliquiose causada por diferentes membros da Família Anaplasmataceae são similares entre si e entre outras enfermidades de manifestação sistêmica. A observação de inclusões em leucócitos e plaquetas não pode ser utilizada para diagnosticar o agente etiológico pertencente à Família Anaplasmataceae. O presente trabalho objetivou detectar, por meio de técnicas moleculares, a presença de agentes da Família Anaplasmataceae em 51 cães de duas diferentes cidades (Jaboticabal, SP e Campo Grande, MS) apresentando sinais clínicos e microscópios sugestivos de erliquiose. DNA de agentes da Família Anaplasmataceae foi amplificado em 46/51 (90,2 por cento) das amostras de sangue; 22 (40 por cento) amostras de Jaboticabal e 10 (18,2 por cento) amostras de Campo Grande foram positivas na nested PCR para E. canis. DNA de Anaplasma platys foi amplificado em duas amostras de Jaboticabal e em 11 de Campo Grande. Análise filogenética dos DNAs de E. canis e A. platys das amostras confirmou o agente etiológico e mostrou que a PCR é o método mais confiável no diagnóstico das infecções por agentes da Família Anaplasmataceae.

Analysis of the 16S rRNA gene of Anaplasma platys detected in dogs from Brazil

Comparison of the partial DNA sequence of the 16S rRNA gene of Anaplasma platys detected in dogs from Ribeirão Preto, Brazil, to sequences of other strains previously deposited in GenBank showed that there are at least three A. platys strains circulating in South America.

A comparação de sequências parciais do gene 16S RNAr de Anaplasma platys detectadas em cães de Ribeirão Preto, Brasil, com sequências de outras linhagens previamente depositadas no GenBank indicam que existem pelo menos três linhagens de A. platys circulando na América do Sul.