An immunosuppressed woman in her seventies with night sweats and weight loss
BACKGROUND: Candidatus Neoehrlichia mikurensis is an emerging tick-borne pathogen with widespread distribution in Ixodes ricinus ticks in Europe and Asia. It has been found to cause chronic infections, particularly in immunosuppressed individuals. Common symptoms include relapsing fever, night sweats and thromboembolic episodes, likely due to endovascular infection.
CASE PRESENTATION: A patient in her seventies developed persistent night sweats and moderate weight loss that persisted for four months prior to evaluation. There was no history of fever or organ-specific symptoms. Prior diseases included a ten-year history of rheumatoid arthritis treated with rituximab. Initial workup revealed moderately increased acute phase reactants, but no evidence of malignant disease or endocrine abnormalities. Night sweats persisted, and after eight months moderate splenic enlargement was observed. PCR revealed presence of Candidatus Neoehrlichia mikurensis DNA, and symptoms resolved promptly after initiation of oral doxycycline treatment.
INTERPRETATION: Infection with anaplasmataceae such as Candidatus Neoehrlichia mikurensis can present with non-specific constitutive symptoms. In this case, persistent night sweats and moderate weight loss were the only manifestations over an eight-month period. Diagnosis is readily established by PCR analysis of whole blood, but a high degree of suspicion and careful assessment of potential exposure is required for timely diagnosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:141 |
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| Enthalten in: |
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke - 141(2021), 17 vom: 23. Nov. |
| Sprache: |
Norwegisch |
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| Weiterer Titel: |
En immunsupprimert kvinne i 70-årene med nattesvette og vekttap |
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| Beteiligte Personen: |
Svendsen, Jan [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 08.12.2021 Date Revised 16.12.2021 published: Electronic-Print Citation Status MEDLINE |
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| doi: |
10.4045/tidsskr.21.0332 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM333504925 |
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| 245 | 1 | 3 | |a An immunosuppressed woman in her seventies with night sweats and weight loss |
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| 520 | |a BACKGROUND: Candidatus Neoehrlichia mikurensis is an emerging tick-borne pathogen with widespread distribution in Ixodes ricinus ticks in Europe and Asia. It has been found to cause chronic infections, particularly in immunosuppressed individuals. Common symptoms include relapsing fever, night sweats and thromboembolic episodes, likely due to endovascular infection | ||
| 520 | |a CASE PRESENTATION: A patient in her seventies developed persistent night sweats and moderate weight loss that persisted for four months prior to evaluation. There was no history of fever or organ-specific symptoms. Prior diseases included a ten-year history of rheumatoid arthritis treated with rituximab. Initial workup revealed moderately increased acute phase reactants, but no evidence of malignant disease or endocrine abnormalities. Night sweats persisted, and after eight months moderate splenic enlargement was observed. PCR revealed presence of Candidatus Neoehrlichia mikurensis DNA, and symptoms resolved promptly after initiation of oral doxycycline treatment | ||
| 520 | |a INTERPRETATION: Infection with anaplasmataceae such as Candidatus Neoehrlichia mikurensis can present with non-specific constitutive symptoms. In this case, persistent night sweats and moderate weight loss were the only manifestations over an eight-month period. Diagnosis is readily established by PCR analysis of whole blood, but a high degree of suspicion and careful assessment of potential exposure is required for timely diagnosis | ||
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| 700 | 1 | |a Brekke, Kristin |e verfasserin |4 aut | |
| 700 | 1 | |a Rønning, Else Johanne |e verfasserin |4 aut | |
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