Department of Internal Medicine, University of Connecticut, 263 Farmington Ave, Farmington, CT 06030, USA.
Am J Emerg Med. 2020 Jul;38(7):1543.e1-1543.e2. doi: 10.1016/j.ajem.2020.03.066. Epub 2020 Apr 2.
Anaplasma phagocytophilum (AP) is the causative agent of human granulocytic anaplasmosis (HGA), a tick-borne illness with highest incidence in north-eastern regions of the United States. This condition presents with vague constitutional symptoms and has been associated with laboratory derangements such as leukopenia, thrombocytopenia and transaminitis1. Rhabdomyolysis, however, is not one of these associations. We report a case of confirmed HGA associated with severe rhabdomyolysis, where no other cause was identified. The etiology of rhabdomyolysis secondary to AP infection is still unknown. A presumptive diagnosis of HGA can be made in the presence of fever, non-specific symptoms such as myalgias, laboratory derangements such as leukopenia and thrombocytopenia in an individual residing in an endemic area3. Serological confirmation should not delay treatment, given the rapid progression of this dangerous infection. Rhabdomyolysis should also be considered as part of supporting data in the diagnostic consideration for HGA.
嗜吞噬细胞无形体（AP）是人类粒细胞无形体病（HGA）的病原体，这是一种蜱传播疾病，发病率最高的地区是美国东北部。这种疾病表现为模糊的全身症状，并与实验室异常有关，如白细胞减少、血小板减少和肝功能异常 1。然而，横纹肌溶解症并不是其中之一。我们报告了一例确诊的 HGA 伴严重横纹肌溶解症，未发现其他病因。继发于 AP 感染的横纹肌溶解症的病因尚不清楚。在流行地区居住的发热患者中，如果出现非特异性症状（如肌痛）、实验室异常（如白细胞减少和血小板减少），可做出疑似 HGA 的诊断 3。鉴于这种危险感染的快速进展，不应因血清学确证而延迟治疗。横纹肌溶解症也应作为支持 HGA 诊断考虑的部分数据。
