Mitja Lenart1, Miha Simoniti2, Katja Strašek-Smrdel3, Vesna Cvitković Špik3, Tanja Selič-Kurinčič2, Tatjana Avšič-Županc3. 1. Department of Infectious diseases, General Hospital Celje, Oblakova ulica 5, 3000, Celje, Slovenia. mitchu88@gmail.com. 2. Department of Infectious diseases, General Hospital Celje, Oblakova ulica 5, 3000, Celje, Slovenia. 3. Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Zaloška cesta 4, Ljubljana, 1000, Slovenia.
Abstract
BACKGROUND: Candidatus Neoehrlichia mikurensis (CNM) is an emerging tick-born pathogen and usually causes symptomatic infection only in immunocompromised patients. Apart from one described case found in the literature where cultivation was successful, all cases so far were diagnosed by using broad-range 16S rDNA PCR. CASE PRESENTATION: Our patient presented with a prolonged febrile state of unknown origin. Clinical presentation, extensive medical workup and classic microbiologic testing were non-conclusive. Several infectious agents and other causes for the febrile state were excluded. In the end, a broad-range 16S rDNA PCR was to be performed to confirm the diagnosis of CNM infection. Treatment was successful with doxycycline. CONCLUSIONS: Due to the obscurity of the pathogen, diagnostic workup in CNM is prolonged and challenging. More awareness is need about this emerging infectious disease in countries with high prevalence of tick-borne diseases as standard microbiological methods are not successful in confirming the diagnosis.
BACKGROUND:Candidatus Neoehrlichia mikurensis (CNM) is an emerging tick-born pathogen and usually causes symptomatic infection only in immunocompromised patients. Apart from one described case found in the literature where cultivation was successful, all cases so far were diagnosed by using broad-range 16S rDNA PCR. CASE PRESENTATION: Our patient presented with a prolonged febrile state of unknown origin. Clinical presentation, extensive medical workup and classic microbiologic testing were non-conclusive. Several infectious agents and other causes for the febrile state were excluded. In the end, a broad-range 16S rDNA PCR was to be performed to confirm the diagnosis of CNM infection. Treatment was successful with doxycycline. CONCLUSIONS: Due to the obscurity of the pathogen, diagnostic workup in CNM is prolonged and challenging. More awareness is need about this emerging infectious disease in countries with high prevalence of tick-borne diseases as standard microbiological methods are not successful in confirming the diagnosis.
Authors: Pedro Paulo V P Diniz; Bianka S Schulz; Katrin Hartmann; Edward B Breitschwerdt Journal: J Clin Microbiol Date: 2011-03-02 Impact factor: 5.948
Authors: Christina Welinder-Olsson; Eva Kjellin; Krista Vaht; Stefan Jacobsson; Christine Wennerås Journal: J Clin Microbiol Date: 2010-03-10 Impact factor: 5.948