First identification of Anaplasma phagocytophilum in both a biting tick Ixodes nipponensis and a patient in Korea: a cas
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CASE REPORT
Open Access
First identification of Anaplasma phagocytophilum in both a biting tick Ixodes nipponensis and a patient in Korea: a case report Seung Hun Lee1, Na-Ri Shin1, Choon-Mee Kim2, Sungdo Park1*, Na Ra Yun3, Dong-Min Kim3* Dong Sik Jung4
and
Abstract Background: Human granulocytic anaplasmosis (HGA) is a tick-borne infectious disease caused by Anaplasma phagocytophilum. To date, there have been no reported cases of A. phagocytophilum infection found in both the biting tick and the patient following a tick bite. Case presentation: An 81-year-old woman presented with fever following a tick bite, with the tick still intact on her body. The patient was diagnosed with HGA. The tick was identified as Ixodes nipponensis by morphological and molecular biological detection methods targeting the 16S rRNA gene. The patient’s blood was cultured after inoculation into the human promyelocytic leukemia cell line HL-60. A. phagocytophilum growth was confirmed via culture and isolation. A. phagocytophilum was identified in both the tick and the patient’s blood by Anaplasma-specific groEL- and ankA-based nested polymerase chain reaction followed by sequencing. Moreover, a four-fold elevation in antibodies was observed in the patient’s blood. Conclusion: We report a case of a patient diagnosed with HGA following admission for fever due to a tick bite. A. phagocytophilum was identified in both the tick and the patient, and A. phagocytophilum was successfully cultured. The present study suggests the need to investigate the possible incrimination of I. nipponensis as a vector for HGA in Korea. Keywords: Human granulocytic anaplasmosis, Tick bites, Anaplasma phagocytophilum, Ixodes nipponensis
* Correspondence: [email protected]; [email protected] 1 Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Osong, Cheongju-si 28159, Chungcheongbuk-do, Republic of Korea 3 Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju 61453, Republic of Korea Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Do
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