AI Article Synopsis
- - Anaplasmosis is a rising infection in the U.S. that is often under-recognized, especially in places like Pennsylvania, and can lead to severe complications like hemophagocytic lymphohistiocytosis (HLH).
- - HLH is a dangerous immune response with high mortality rates, but prompting recognition and treatment of anaplasmosis can be life-saving, with early use of doxycycline crucial.
- - A successful treatment case showcased combining doxycycline, steroids, and anakinra for anaplasmosis-induced HLH, demonstrating that both antibiotics and immune suppression can effectively manage this serious condition.
Article Abstract
Anaplasmosis is an emerging infection in the United States and remains under-recognized in many areas including Pennsylvania. Presenting signs and symptoms are often nonspecific, but fulminant infection can occur in vulnerable populations. We present two cases of severe anaplasmosis that progressed to secondary hemophagocytic lymphohistiocytosis (HLH). This severe immune dysregulation syndrome has an extremely high mortality, but anaplasmosis represents one of the few treatable underlying etiologies. It is imperative for physicians to recognize this complication and start empiric doxycycline, as early treatment improves mortality. We also present a case of anaplasmosis-induced HLH successfully treated with a combination of doxycycline, steroids, and anakinra (an IL-1 receptor antagonist), highlighting that this primarily immune-mediated complication is amenable to treatment with both antibiotics and immune suppression.
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| http://dx.doi.org/10.1016/j.ttbdis.2020.101468 | DOI Listing |
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