Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden - Volume 21, Number 8—August 2015 - Emerging Infectious Disease journal - CDC

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Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden - Volume 21, Number 8—August 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 8—August 2015

Dispatch

Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden

On This Page

• The Study
• Conclusions
• Suggested Citation

Figures

• Figure 1
• Figure 2

Tables

• Table 1
• Table 2

Technical Appendicies

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• PDF[631 KB - 4 pgs]
• RIS[TXT - 2 KB]

Anna Grankvist1, Lisa Labbé Sandelin1, Jennie Andersson, Linda Fryland, Peter Wilhelmsson, Per-Eric Lindgren, Pia Forsberg, and Christine Wennerås 

Author affiliations: University of Gothenburg, Göteborg, Sweden (A. Grankvist, J. Andersson, C. Wennerås);Sahlgrenska University Hospital, Göteborg (A. Grankvist, J. Andersson, C. Wennerås); Kalmar County Hospital, Kalmar, Sweden (L.L. Sandelin); Uppsala University, Uppsala, Sweden (L.L. Sandelin); Linköping University, Linköping, Sweden (L. Fryland, P. Wilhelmsson, P.-E. Lindgren, P. Forsberg); County Hospital Ryhov, Jönköping, Sweden (P.-E. Lindgren)

Suggested citation for this article

Abstract

The prevalence of Candidatus Neoehrlichia mikurensis infection was determined in 102 persons bitten by ticks in Sweden. Two infected women had erythematous rashes; 1 was co-infected with a Borrelia sp., and the other showed seroconversion for Anaplasma phagocytophilum. Both patients had increased levels ofNeoehrlichia DNA and serum cytokines for several months.

Candidatus Neoehrlichia mikurensis is a tick-borne pathogen found in Europe and Asia (1). It causes an infectious disease in immunocompromised persons that is characterized by fever and thromboembolic events (2). In contrast, Candidatus N. mikurensis infection in immunocompetent hosts has been linked to asymptomatic infection (3), systemic inflammation with various symptoms (4,5), and possibly lethal infection (6). Knowledge regarding the capacity of Candidatus N. mikurensis to cause disease in immunocompetent persons is still limited. The purpose of this study was to investigate the prevalence, rate of co-infections, clinical picture, and cytokine response to Candidatus N. mikurensis infection in immunocompetent patients participating in the Tick-Borne Diseases Study (Technical Appendix[PDF - 255 KB - 3 pages]).

Dr. Grankvist is a molecular biologist in the Department of Clinical Microbiology at Sahlgrenska University Hospital, Göteborg, Sweden. Her research interests are noncultivatable infectious agents, with a focus onCandidatus N. mikurensis.

Acknowledgment

This study was supported by ALF-Göteborg (71580); the Cancer and Allergy Foundation (149781); Västra Götaland Region Research and Development (94510); Laboratory Medicine at Sahlgrenska University Hospital (6333); the Medical Research Council of South-East Sweden (FORSS-297311, -307591, and -87231); The Swedish Research Council/Medicine (2011-345); and ALF-Östergötland.

References

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Figures

• Figure 1. Proinflammatory cytokines in 2 patients infected with Candidatus Neoehrlichia mikurensis, Sweden. Concentrations of cytokines A) interleukin-1β (IL-1β), B) tumor necrosis factor-α (TNF-α), C) interleukin-6 (IL-6), and D) macrophage inflammatory...
• Figure 2. Th1 cytokines in 2 patients infected with Candidatus Neoehrlichia mikurensis, Sweden. Concentrations of cytokines A) interleukin-12p70 (IL-12p70), B) interferon-γ (IFN-γ), C) monocyte chemoattractant protein-1 (MCP-1) (C), and D) IFN-γ−induced...

Tables

• Table 1. Evolution of Candidatus Neoehrlichia mikurensis gene copy numbers and antibody levels to Borrelia burgdorferi sensu lato complex andAnaplasma phagocytophilum for patient 1, Sweden
• Table 2. Evolution of Candidatus Neoehrlichia mikurensis gene copy numbers and antibody levels to Borrelia burgdorferi sensu lato complex andAnaplasma phagocytophilum for patient 2, Sweden

Technical Appendix

• . Tick-borne disease study design and pan-bacterial PCR.  255 KB

Suggested citation for this article: Grankvist A, Sandelin LL, Andersson J, Fryland L, Wilhelmsson P, Lindgren P-E, et al. Infections with CandidatusNeoehrlichia mikurensis and cytokine responses in 2 persons bitten by ticks, Sweden. Emerg Infect Dis. 2015 Aug [date cited].http://dx.doi.org/10.3201/eid2108.150060

DOI: 10.3201/eid2108.150060

1These authors contributed equally to this article.