Human granulocytic anaplasmosis.
Human granulocytic anaplasmosis.
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DOI：
10.1016/j.idc.2015.02.007
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发表时间：
2015-06
影响因子：
4.4
通讯作者：
Dumler JS
中科院分区：
文献类型：
--
作者：
Bakken JS;Dumler JS
人粒细胞无形体病（HGA）是一种由嗜吞噬细胞无形体引起的鹿蜱传播立克次体感染，是美国东北部和上中西部地区未分化发热的常见原因。然而，多达3%的人可能会出现危及生命的并发症，近1%的人死于感染。因此，即使在没有已知的蜱叮咬、血膜检查阴性或特定A的结果待定的情况下，蜱叮咬史和高度的临床怀疑也值得考虑在成人和儿童中使用强力霉素治疗。嗜吞噬细胞菌诊断试验，如配对血清学或PCR对急性期血液。抗体测试和滴度不应用于监测活动性感染，因为可检测的抗体可以持续存在多年。此外，从未报告过持续感染。虽然伯氏疏螺旋体和田鼠巴氏疏螺旋体的合并感染发生，但几乎没有证据表明疾病的协同作用或A。嗜吞噬细胞菌在慢性疾病中的作用预防措施包括避免蜱虫出没的地区，使用蜱虫驱虫剂，并仔细搜索皮肤以清除附着的蜱虫;没有疫苗可用。
Human granulocytic anaplasmosis (HGA), a deer tick transmitted rickettsial infection caused by Anaplasma phagocytophilum, is a common cause of undifferentiated fever in the Northeast and Upper Midwest U.S. Patients are often initially diagnosed with a mild viral infection, and illness readily resolves in most cases. However, as many as 3% may develop life threatening complications and nearly 1% die from the infection. A history of tick bite and a high degree of clinical suspicion thus warrant consideration for doxycycline treatment in both adults and children, even in the absence of known tick bite, a negative blood film examination, or pending results of specific A. phagocytophilum diagnostic tests such as paired serology or PCR on acute phase blood. Antibody tests and titers should not be used to monitor active infection as detectable antibodies can remain present for years. Moreover, persistent infection has never been reported. While co-infections with Borrelia burgdorferi and Babesia microti occur, there is little evidence to suggest synergism of disease or a role for A. phagocytophilum in chronic illness. Preventive measures include avoiding tick-infested areas, use of tick repellents, and careful searches of skin to remove attached ticks; no vaccine is available.
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影响因子：
11.8
作者：
Bakken, JS;Dumler, JS
通讯作者：
Dumler, JS
影响因子：
4.9
作者：
Branger, S;Rolain, JM;Raoult, D
通讯作者：
Raoult, D
影响因子：
5.9
作者：
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通讯作者：
Anderson, JF
影响因子：
11.8
作者：
Belongia, EA;Reed, KD;Kazmierczak, JJ
通讯作者：
Kazmierczak, JJ
影响因子：
6.4
作者：
Belongia, EA;Gale, CM;Davis, JP
通讯作者：
Davis, JP