A Febrile Illness from a Visitor from Upstate New York
The Journal of Clinical Microbiology (Thorburn C., et al.) 10.24.2023, published “The Brief Case: A febrile illness from a pesky passenger from Upstate New York.” This article discusses a case of an 80-year-old man who presented to the emergency department with a febrile illness characterized by weakness, fever, and altered mental status.
The patient had recently traveled to upstate New York and had a dental procedure before his symptoms began. Initial tests and examinations did not reveal the cause of his illness, and he was started on antibiotics. Despite antibiotic treatment with cefepime and vancomycin, the patient’s condition did not improve. It was suspected that the patient might have contracted a tick-borne illness due to his recent travel history.
Testing for diseases like Lyme disease, ehrlichiosis, anaplasmosis, and West Nile virus was ordered. Oral doxycycline was initiated as a potential treatment for tick-borne diseases. Within 24 hours of starting doxycycline, the patient’s fever subsided, and his mental state improved. The pathologist’s review of a blood smear identified rare neutrophils with intracytoplasmic inclusions suggesting Anaplasma phagocytophilum infection. Subsequent testing confirmed the presence of A. phagocytophilum in the patient’s blood. It was later discovered that the patient had an attached tick on his body, which was identified as an Ixodes species.
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