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Volume 28, Number 8—August 2022
Dispatch

Spiroplasma ixodetis Infections in Immunocompetent and Immunosuppressed Patients after Tick Exposure, Sweden

Johannes Eimer12, Louise Fernström2, Louise Rohlén, Anna Grankvist, Kristoffer Loo, Erik Nyman, Anna J. Henningsson, Mats Haglund, Viktor Hultqvist, Johanna Sjöwall, Christine Wennerås3, and Thomas Schön3Comments to Author 
Author affiliations: Visby County Hospital, Visby, Sweden (J. Eimer, E. Nyman); Linköping University, Linköping, Sweden (L. Fernström, L. Rohlén, K. Loo, A.J. Henningsson, M. Haglund, V. Hultqvist, J. Sjöwall, T. Schön); Kalmar County Hospital, Kalmar, Sweden (L. Fernström, L. Rohlén, K. Loo, M. Haglund, V. Hultqvist, T. Schön); Sahlgrenska University Hospital, Gothenburg, Sweden (A. Grankvist, C. Wennerås); Jönköping County Hospital, Jönköping, Sweden (A.J, Henningsson); Linköping University Hospital, Linköping, Sweden (J. Sjöwall, T. Schön); University of Gothenburg, Gothenburg (C. Wennerås)

Main Article

Table

Results of analysis for Spiroplasma ixodetis infections in immunocompetent and immunosuppressed patients after tick exposure, Sweden*

Analysis Reference value Case-patient 1, immunocompetent†
 Case-patient 2, immunosuppressed‡
D0 D1 D2 D16 D0 D2 D4 D25
Clinical chemistry
Blood
Hemoglobin, g/L 134–170 143 162 NT 145 114 118 110 108
Leukocytes, × 109 cells/L 3.5–8.8 4.2 3.0 NT 6.4 6.1 6.4 8.8 6.4
Lymphocytes, × 109 cells/L 1.1–3.5 NT NT NT 1.9 0.3 NT 0.6 NT
Neutrophils, × 109 cells/L 1.6–5.9 NT NT NT 3.7 4.9 NT 7.7 NT
Platelet count, × 109/L 140–350 150 118 NT 287 47 43 41 159
Plasma
ALT, μkat/L <1.1 1.6 2.1 NT 0.85 3.82 8.18 13.34 0.48
Creatinine, μmol/L 45–90 66 73 NT 72 75 90 149 71
CRP, mg/L
 <5
 59
 59
 38
 <1
197
 158
 164
 <3
Vital signs
O2 saturation, % 95‒100 95 95 97 95 97 97 NT
Respiratory rate, breathes/min 12‒16 20 18 20 20 24 20 NT
Blood pressure, mm Hg 90/60‒120/80 108/50 94/69 114/56 117/72 119/66 120/74 NT
Heart rate, beats/min 60‒100 66 90 79 73 74 94 NT
Temperature, °C
 37
 38.6
 37.4
 36.2
37.1
 39.9
 36.4
 NT
Immunology/microbiology
Serum
IgG1, g/L 4.0–10 NT NT NT 7.0 NT NT NT NT
IgG2, g/L 1.7–7.9 NT NT NT 3.4 NT NT NT NT
IgG3, g/L 0.1–0.85 NT NT NT 0.48 NT NT NT NT
IgG4, g/L 0.03–2 NT NT NT 0.15 NT NT NT NT
IgA, g/L 0.9–4.5 NT NT NT 3.7 NT 2.4 NT NT
IgG, g/L 6.7–15 NT NT NT 12 NT 10.6 NT NT
IgM, g/L
 0.3–2.1
 NT
 NT
 NT
 2.7
NT
 0.80
 NT
 NT
Blood culture NR ‒ NT NT NT ‒ NT NT NT
Urine culture
 NR
 ‒
 NT
 NT
 NT
‒
 NT
 NT
 NT
COVID-19 PCR/rapid test NR ‒ NT NT NT ‒ NT NT NT

*Day 0 indicates day of admission. ALT, alanine aminotransferase; COVID-19, coronavirus disease; CRP, C-reactive protein; D, day; NT, not tested; NR, not relevant; ‒, negative. †Case-patient 1 had negative PCR results for Anaplasma spp. and Neoerlichia spp. at admission to the emergency department. ‡Case-patient 2 had negative PCR results in serum for Anaplasma spp. and Neoerlichia spp. at admission, as well as negative IgG results for Anaplasma spp. Results were positive in serum for IgG against Borrelia burgdorferi and tick borne encephalitis virus, which were compatible with past infection. Molecular testing (DNA) for Epstein-Barr virus, cytomegalovirus, adenovirus, and parvovirus B19 showed negative results. Test results were negative for antinuclear antibodies and antineutrophil cytoplasmic antibodies, and urine sediment test result was unremarkable.

Main Article

1Current affiliation: Sorbonne University, Paris, France.

2These authors contributed equally to this article.

3These senior authors contributed equally to this article.

Page created: June 03, 2022
Page updated: July 20, 2022
Page reviewed: July 20, 2022
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