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Volume 21, Number 8—August 2015
Dispatch

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

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

Main Article

Table 1

Evolution of Candidatus Neoehrlichia mikurensis gene copy numbers and antibody levels to Borrelia burgdorferi sensu lato complex and Anaplasma phagocytophilum for patient 1, Sweden

Characteristic
 Days after inclusion in study
0
 77
 169
Clinical manifestations None Rash on right breast None
Candidatus N. mikurensis DNA in plasma, gene copies/mL 0 2,200 2,000
Serum B. burgdorferi sensu lato IgM (points)* Negative (4) Positive (12) Positive (8)
B. burgdorferi sensu lato antigens
Positive reactivity
 None
 OspC, p100
 OspC
Borderline reactivity None None None
Serum B. burgdorferi sensu lato IgG (points)† Positive (13) Positive (16) Positive (16)
B. burgdorferi sensu lato antigens
Positive reactivity
 P100, VlsE, p58
 P100, VlsE, p58, OspC
 P100, VlsE, p58, OspC
Borderline reactivity
 OspC
 None
 None
Serum A. phagocytophilum IgG (1:64)‡ ++ ++ ++
Serum A. phagocytophilum IgG (1:256)§ + + +

*Reactivity to either outer surface protein C (OspC) alone or to 2 antigens was required for a positive IgM response.
†Reactivity to >2 antigens was required for a positive IgG response. Full reactivity to an antigen is indicated by 4 points.
‡Every serum sample was tested at a dilution of 1/64. ++, strongly positive; +, positive.
§Samples that showed a positive (+) result were further tested at dilutions of 1:128 and 1:256.

Main Article

1These authors contributed equally to this article.

Page created: July 15, 2015
Page updated: July 15, 2015
Page reviewed: July 15, 2015
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