Acute anaplasmosis in humans in Cyprus

Abstract

A 27-year-old woman was admitted on 14 May 2007, into the hospital of Famagusta (Cyprus) with an 11-day fever (up to 39.5 C). She reported no direct contact with domestic animals or ticks; however, she lived in a rural area, where sheep and goats are abundant. On physical examination, hepatosplenomegaly and an enlarged lymph node were observed. Initial laboratory examination demonstrated moderate anaemia (Hb 11.5 g ⁄dL), thrombocytopenia (PLT 95000), increased transaminases (AST 178 u ⁄L, ALT 313 u ⁄L), cGT (79 u ⁄L), LDH (698 u ⁄L) and increased CRP (10.4 mg ⁄L) and ESR (80 mm ⁄h). The electrocardiogram and the chest axial tomography were negative, as were blood cultures, antibody tests against CMV, EBV, hepatitis, HIV, mycoplasma, coxackievirus, adenovirus and parvovirus and tests for rheumatoid disease. The patient was treated with doxycycline (200 mg ⁄day for 11 days), ceftriaxone (2 g ⁄day for 5 days) and imipenem-cilastatin (1500 mg ⁄day for 1 day), recovered and was discharged 17 days after hospitalisation. Blood samples were taken from the patient on admission into the hospital, and 7 days and 3 months later.