Margini, Cristina; Maldonado, Rafaela; Keller, Peter; Banz, Yara; Escher, Robert; Waldegg, Gabriel (2023). Fever of Unknown Origin, a Vascular Event, and Immunosuppression in Tick-Endemic Areas: Think About Neoehrlichiosis. Cureus, 15(6), e40617. Springer Nature Group 10.7759/cureus.40617
Full text not available from this repository. (Request a copy)Three patients were referred to our hospital because of fever of unknown origin (FUO) and thrombosis or thrombophlebitis. All of them had been under immunosuppression (IS) with rituximab. Intensive diagnostics for FUO and blood cultures remained negative. Finally, the association of fever, immunosuppression, and a vascular event led to the suspicion of Candidatus Neoehrlichia mikurensis (CNM) infection. The diagnosis was confirmed by species-specific polymerase chain reaction (PCR) in the peripheral blood. Therapy with doxycycline or rifampicin led to the resolution of the disease. A liver biopsy was performed in one patient due to hepatomegaly and elevated liver enzymes demonstrating hemophagocytosis. To our knowledge, this is the first histopathological study of liver tissue in CNM infection. The evidence of hemophagocytosis raises the question of whether symptomatic CNM infection might be in part related to host inflammatory and immune responses.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research 04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology 04 Faculty of Medicine > Service Sector > Institute of Pathology |
UniBE Contributor: |
Keller, Peter Michael, Banz Wälti, Yara Sarah |
Subjects: |
600 Technology > 610 Medicine & health 500 Science > 570 Life sciences; biology |
ISSN: |
2168-8184 |
Publisher: |
Springer Nature Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
24 Jul 2023 12:03 |
Last Modified: |
20 Aug 2023 02:36 |
Publisher DOI: |
10.7759/cureus.40617 |
PubMed ID: |
37476120 |
Uncontrolled Keywords: |
candidatus neoehrlichia mikurensis fever of unknown origin hemophagocytosis liver biopsy rituximab |
URI: |
https://boris.unibe.ch/id/eprint/184988 |
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