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Table 3 Overview of clinical findings in HGA patients

From: A review on the eco-epidemiology and clinical management of human granulocytic anaplasmosis and its agent in Europe

Country

Age

Tb

I

Clinical signs

Laboratory findings

D

H

T

References

Austria

33

+

8

Fever, arthralgia, headache

Thrombocytopenia; increased levels of CRP, lactate dehydrogenase and bilirubin

S

+

+

[146]

33

+

7

Fever, headache, sweats, splenomegaly

Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, neopterin; elevated erythrocyte sedimentation rate

S

+

+

[94]

40

+

n

Fever, arthralgia, headache, sweats

Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, procalcitonin, neopterin; elevated erythrocyte sedimentation rate

S

+

+

63

+

8

Fever, arthralgia, headache, vertigo, sweats, splenomegaly

Thrombocytopenia; increased levels of CRP, lactate dehydrogenase, neopterin; elevated erythrocyte sedimentation rate

S

+

+

46

+

6

Fever, arthralgia, headache, sweats, splenomegaly

Thrombocytopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, neopterin; elevated erythrocyte sedimentation rate

S

32

n

Fever, arthralgia, headache, sweats

Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, procalcitonin, neopterin; elevated erythrocyte sedimentation rate

S

+

+

38

+

9

Fever, myalgia, arthralgia, headache

Increased levels of CRP and creatine kinase

P

+

+

[95]

France

47

n

Fever, myalgia, arthralgia, headache, sweats, cough (atypical pneumonitis)

Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase and fibrinogen

P

+

+

[101]

Italy

33

+

n

nd

S

n

+

[118]

69

+

n

nd

S

n

+

41

+

n

Fever, myalgia, arthralgia

nd

S

n

+

48

+

n

EM

nd

S

n

+

17

+

n

Fever, myalgia, arthralgia, headache, nucal rigidity, aseptic meningitis

nd

S

n

+

Netherlands

58

n

Fever, chills, diarrhea

Thrombocytopenia; leucopenia; increased levels of AST/ALT

P

+

+

[106]

Poland

40

n

Fever, headache, hepatomegaly

Thrombocytopenia; increased levels of CRP, AST/ALT

P

+

+

[109]

41

+

7

Fever, headache, meningeal signs, vertigo, weakness, hepatomegaly

Thrombocytopenia; increased levels of AST/ALT

S

+

+

22

+

7

Fever, headache, vomiting, abdominal pain, diarrhea, splenomegaly

Thrombocytopenia; leucopenia; increased levels of AST/ALT

P

+

+

Scotland

40

+

3

Lactate dehydrogenase (248 U/L)

S

n

+

[74]

Slovenia

11

9

Fever, headache, conjunctivitis, erythematous throat, abdominal pain (right upper quadrant abdominal tenderness)

Thrombocytopenia; leucopenia; increased levels of CRP

P

+

+

[147]

36

10

Tachypnea, tachycardia, hypotension, ARDS

Thrombocytopenia; increased levels of CRP, AST/ALT

P

+

+

[75]

70

+

12

Fever, myalgia, arthralgia, headache, vomiting, conjunctivitis, lymphadenopathy

Thrombocytopenia; increased levels of CRP

P

[91]

59

+

21

Fever, myalgia, arthralgia, headache, chills, vertigo

Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT

S

+

+

[148]

43

+

7

Fever, myalgia, arthralgia, headache, chills, vertigo, dry cough (pneumonia)

Increased levels of CRP, AST/ALT

S

+

+

55

+

30

Fever, myalgia, arthralgia, headache, vertigo, vomiting

Thrombocytopenia; leucopenia; increased levels of CRP

P

36

+

15

Fever, arthralgia, headache, chills, vomiting, lymphadenopathy, hepatosplenomegaly

Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT

S

+

[149]

22

+

n

Fever, myalgia, arthralgia, headache, conjunctivitis, EM

Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT

S

+

+

[150]

63

+

 

Fever, myalgia, arthralgia, headache

Thrombocytopenia; leucopenia; increased levels of CRP, procalcitonin

P

+

+

[151]

14

+

n

Fever, chills, neck and lumbar pain and passing of dark urine, jaundice and a discrete maculopapular rash on the trunk and neck, systolic murmur

Thrombocytopenia, leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, bilirubin

P

+

+

[152]

Spain

19

+

15

Fever, myalgia, headache, abdominal pain

Thrombocytopenia, leucopenia; increased levels of AST/ALT

P

+

+

[113]

Sweden

41

n

Fever, myalgia, headache, bilateral conjunctivitis, tachypnea, diffuse rash on the face and trunk, dry cough and dyspnea (bilateral interstitial infiltrates)

Increased levels of CRP, AST/ALT; intrahepatic cholestasis with increased serum bilirubin, serum alkaline phosphatase and serum glutamyl transpeptidase

P

+

+

[133]

5

n

n

Fever, headache, facial palsy

nd

P

+

n

[132]

41

n

n

Fever, headache, dyspnea, cough, conjunctivitis, rash

Increased levels of AST/ALT

P

+

+

32

+

30

Fever, headache, chills, stiff neck

Thrombocytopenia

P

+

+

  1. Abbreviations: Tb, history of tick bite; I, incubation (days); nd, not determined; D, diagnostic: S, serology; P, PCR; H, hospitalization; T, treatment received; n, not specified; −, no; +, yes
  2. Note: the table is based on 33 cases