Human Granulocytic Anaplasmosis in the Setting of a Hunting Injury

Publication date: Available online 25 January 2016 Source:IDCases Author(s): Joseph DeRose Human Granulocytic Anaplasmosis is a traditionally tick borne illness characterized by non-specific symptoms. 63 year old man with medical history of HIV on ART, presented to EO-VAMC with a complaint of cyclic fevers, chills, and diarrhea. Symptoms began with generalized weakness one week prior to presentation. Patient revealed he was a hunter and experienced trauma to his hand while butchering a deer. He denied vomiting, hematemesis, sick contacts, changes in diet, shortness of breath, recent travel or known tick exposure. Patient was tachycardic, ill-appearing and was admitted to MICU. Initial labs were significant for thrombocytopenia, coagulopathy and transaminitis. He was fluid resuscitated and Infectious Disease service was consulted. He was started on broad spectrum antibiotics given his recent hunting injury and possible tick exposure. The patient's clinical status improved throughout his hospital stay and he was discharged on Azithromycin, Atovoquone and Doxycycline. The patient returned to ID clinic two weeks after discharge and reported complete resolution of symptoms. Titers at that time revealed (+) IgM against HGA and re-examination of the peripheral smear revealed intraleukocytic morulae characteristic of Erlichia/Anaplasmosis infection. Given patient's history of trauma while butchering a deer, timeline of symptoms and positive Anaplasmosis serology, diagnosis of H...
Source: IDCases - Category: Infectious Diseases Source Type: research