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Comment & Response
July 5, 2016

Human Granulocytic Anaplasmosis and Lyme Disease

Author Affiliations
  • 1Division of Infectious Diseases, New York Medical College, Valhalla
JAMA. 2016;316(1):98-99. doi:10.1001/jama.2016.4292

To the Editor Human granulocytic anaplasmosis (HGA), caused by the rickettsia Anaplasma phagocytophilum, is vectored by the same Ixodes spp ticks that transmit Lyme disease. HGA is associated with fever, headache, cytopenia, and rarely mortality (if the infection occurs in elderly or immunocompromised hosts). HGA is not spread person-to-person by mucocutaneous exposure to the blood of infected patients; does not typically, or perhaps ever, cause bleeding from multiple body sites; is not usually associated with diarrhea; and has never been associated with relative bradycardia. Convalescent phase antibody titers to the etiologic agent reach 640 or greater in more than 90% of culture-confirmed cases in the United States, and morulae are detected on blood smears in more than 70% of such cases.1

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