Department of Laboratory Medicine, Chungbuk National University Hospital, Republic of Korea.
Department of Laboratory Medicine, Chungbuk National University College of Medicine, Republic of Korea.
Jpn J Infect Dis. 2020 Nov 24;73(6):469-472. doi: 10.7883/yoken.JJID.2020.013. Epub 2020 May 29.
We report a case of human granulocytic anaplasmosis (HGA) in a 76-year-old woman, diagnosed rapidly based on the characteristic peripheral blood smear finding of intragranulocytic morulae. The smear was prepared on the day of hospitalization, which was 1-2 weeks before results of the serology test or polymerase chain reaction (PCR) became available. Owing to the blood smear test, we could start timely and appropriate antimicrobial treatment. The sensitivity of peripheral blood smear is lower compared to that of serology or PCR for the diagnosis of HGA but may increase with the examiner's experience. In our case, the diagnosis of HGA was confirmed based on PCR and serology 7 and 14 days after the positive peripheral blood smear test, respectively. Morulae in neutrophils are a diagnostic indicator of HGA, particularly for febrile patients with a history of tick bites or outdoor activities in rural areas.
我们报告了一例 76 岁女性人类粒细胞无形体病（HGA），根据外周血涂片中性粒细胞内出现的典型菌样体特征，迅速做出诊断。该涂片是在患者住院当天，即血清学检测或聚合酶链反应（PCR）结果出来前 1-2 周制备的。由于血涂片检测，我们能够及时进行适当的抗菌治疗。与血清学或 PCR 相比，外周血涂片检测诊断 HGA 的敏感性较低，但随着检查者经验的增加，敏感性可能会提高。在我们的病例中，PCR 和血清学检测分别在阳性外周血涂片检测后 7 天和 14 天确诊 HGA。中性粒细胞内的菌样体是 HGA 的诊断指标，特别是对于有蜱虫叮咬史或在农村地区有户外活动史的发热患者。
