Memon Aurangzeb, Abdelghany Abdelmalek, Abusuliman Mohammed, Eldesouki Mohamed, Fatima Minahil, Abdelhalim Omar, Abosheaishaa Hazem
Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.
Internal Medicine, Faculty of Medicine, October 6 University, Cairo, EGY.
Cureus. 2023 Sep 11;15(9):e45020. doi: 10.7759/cureus.45020. eCollection 2023 Sep.
Human granulocytic anaplasmosis (HGA) is a disease caused by tick-borne infection of Anaplasma phagocytophilum. The typical symptoms are fever, malaise, and body aches accompanied by abnormal blood tests such as leukopenia, thrombocytopenia, and transaminitis. Some rare complications may occur, especially in patients living in heavily wooded areas, with a mean age of 70 years. We present a case of a 67-year-old male who was admitted for lower abdominal pain, fever, and diarrhea with derangement of his blood tests. Despite treatment, his condition deteriorated and complicated rhabdomyolysis and acute kidney dysfunction. Empiric treatment including doxycycline was initiated while waiting for the infection blood work results. PCR came back positive for HGA. Empiric therapy was narrowed down to doxycycline for 14 days, and the patient's condition began to improve gradually and steadily. Aggressive hydration markedly improved rhabdomyolysis and, in turn, kidney function. Our case underscores the importance of considering HGA in ambiguous clinical scenarios and highlights the value of early diagnosis, empiric treatment, and intravenous hydration, especially in the presence of rhabdomyolysis.
人粒细胞无形体病（HGA）是一种由蜱传播的嗜吞噬细胞无形体感染引起的疾病。典型症状为发热、不适和全身疼痛，并伴有白细胞减少、血小板减少和转氨酶升高等血液检查异常。可能会出现一些罕见的并发症，尤其是在居住在树木繁茂地区、平均年龄为70岁的患者中。我们报告一例67岁男性患者，因下腹痛、发热和腹泻入院，血液检查结果异常。尽管进行了治疗，但其病情仍恶化，并出现横纹肌溶解和急性肾功能障碍。在等待感染血液检查结果期间，开始了包括强力霉素在内的经验性治疗。PCR检测结果显示HGA呈阳性。经验性治疗方案缩小为使用强力霉素治疗14天，患者的病情开始逐渐稳定改善。积极补液显著改善了横纹肌溶解，进而改善了肾功能。我们的病例强调了在不明确的临床情况下考虑HGA的重要性，并突出了早期诊断、经验性治疗和静脉补液的价值，尤其是在存在横纹肌溶解的情况下。
