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Assessment of Anaplasma phagocytophilum presence in early Lyme borreliosis manifested by erythema migrans skin lesions. 2020

Anna Moniuszko-Malinowska, and Justyna Dunaj, and Martin O Andersson, and Piotr Czupryna, and Joanna Zajkowska, and Katarzyna Guziejko, and Adam Garkowski, and Sambor Grygorczuk, and Maciej Kondrusik, and Sławomir Pancewicz
Department of Infectious Diseases and Neuroinfections Medical University in Białystok, Żurawia 14, 15-540, Białystok, Poland. Electronic address: anna.moniuszko@umb.edu.pl.

To investigate to what extent early Lyme borreliosis patients with erythema migrans are infected with Anaplasma phagocytophilum. Three hundred ten patients from Poland with erythema migrans were included in the study. One hundred and eighty-three patients (59%) agreed to have both skin biopsy and blood samples analysed for Borrelia burgdorferi, A. phagocytophilum and 'Candidatus Neoehrlichia mikurensis', with PCR. Positive samples were confirmed with sequencing. B. burgdorferi DNA was detected in 49.7% of the skin samples and in 1.1% of the blood samples. A. phagocytophilum DNA was found in 7.1% blood samples, and in 8.2% of the skin biopsies. In four patients, A. phagocytophilum DNA was detected only in blood; in one case A. phagocytophilum DNA was found simultaneously in blood and skin, and additionally in this patients' blood Borrelia DNA was detected. In four skin samples B. burgdorferi DNA was detected simultaneously with A. phagocytophilum DNA, indicative of a co-infection. A. phagocytophilum may be present in early Lyme borreliosis characterized by erythema migrans and should always be considered as a differential diagnostic following a tick bite and considered in treatment schemes, as these differs (in early stage of Lyme borreliosis doxycycline, amoxicillin, cefuroxime axetil and azithromycin are recommended, while in anaplasmosis the most effective courses of treatment are doxycycline, rifampin and levofloxacin). Consequently, the role of A. phagocytophilum in erythema migrans should be further studied.

UI MeSH Term Description Entries
D008193 Lyme Disease An infectious disease caused by a spirochete, BORRELIA BURGDORFERI, which is transmitted chiefly by Ixodes dammini (see IXODES) and pacificus ticks in the United States and Ixodes ricinis (see IXODES) in Europe. It is a disease with early and late cutaneous manifestations plus involvement of the nervous system, heart, eye, and joints in variable combinations. The disease was formerly known as Lyme arthritis and first discovered at Old Lyme, Connecticut. Lyme Borreliosis,B. burgdorferi Infection,Borrelia burgdorferi Infection,Lyme Arthritis,Arthritis, Lyme,B. burgdorferi Infections,Borrelia burgdorferi Infections,Borreliosis, Lyme,Disease, Lyme
D004890 Erythema Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes. Erythemas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D015787 Erythema Chronicum Migrans A deep type of gyrate erythema that follows a bite by an ixodid tick; it is a stage-1 manifestation of LYME DISEASE. The site of the bite is characterized by a red papule that expands peripherally as a nonscaling, palpable band that clears centrally. This condition is often associated with systemic symptoms such as chills, fever, headache, malaise, nausea, vomiting, fatigue, backache, and stiff neck. Erythema Migrans of Lyme Disease
D025065 Borrelia burgdorferi A specific species of bacteria, part of the BORRELIA BURGDORFERI GROUP, whose common name is Lyme disease spirochete. Borrelia burgdorferi sensu stricto,Lyme Disease Spirochete
D041081 Anaplasma phagocytophilum A species of gram-negative bacteria in the genus ANAPLASMA, family ANAPLASMATACEAE, formerly called Ehrlichia phagocytophila or Ehrlichia equi. This organism is tick-borne (IXODES) and causes disease in horses and sheep. In humans, it causes human granulocytic EHRLICHIOSIS. Cytoecetes phagocytophila,Ehrlichia equi,Ehrlichia phagocytophila,HGE Agent

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