Abstract
BackgroundCandidatus Neoehrlichia mikurensis (CNM) is an emerging tick-born pathogen and usually causes symptomatic infection only in immunocompromised patients. Apart from one described case found in the literature where cultivation was successful, all cases so far were diagnosed by using broad-range 16S rDNA PCR.Case presentationOur patient presented with a prolonged febrile state of unknown origin. Clinical presentation, extensive medical workup and classic microbiologic testing were non-conclusive. Several infectious agents and other causes for the febrile state were excluded. In the end, a broad-range 16S rDNA PCR was to be performed to confirm the diagnosis of CNM infection. Treatment was successful with doxycycline.ConclusionsDue to the obscurity of the pathogen, diagnostic workup in CNM is prolonged and challenging. More awareness is need about this emerging infectious disease in countries with high prevalence of tick-borne diseases as standard microbiological methods are not successful in confirming the diagnosis.
Highlights
Candidatus Neoehrlichia mikurensis (CNM) is an emerging tick-born pathogen and usually causes symptomatic infection only in immunocompromised patients
In 2010, the first case of an immunocompromised patient with recurrent episodes of fever was described in Sweden [1]
An infectious disease specialist was consulted, blood cultures were drawn, empirical antibiotic treatment with amoxicillin/clavulanic acid (1200 mg/8 h i.v.) was started and the patient was admitted to the hospital for further workup (Nov.4th 2019)
Summary
Candidatus Neoehrlichia mikurensis seems to be an emerging tick-borne pathogen mostly presenting as a prolonged intermittent episodes of fever in immunocompromised patients. As there are no specific biochemical markers, clinical signs or serological assays and the cultivation from blood cultures is unsuccessful, the only method of confirming the diagnosis so far is the specific and/or broad range 16rRNA PCR. Four weeks of doxycycline was effective for the case described above
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
