Human granulocytic anaplasmosis in Poland: clinical déjà vu or a new chapter in tick-borne diseases?

OBJECTIVES

Tick-borne diseases represent an increasing public health concern worldwide, including human granulocytic anaplasmosis (HGA). HGA is gaining relevance in travel medicine due to its expanding geographic distribution. Its true incidence remains unknown, largely due to underreporting and diagnostic challenges. HGA manifests itself by nonspecific symptoms and may be misdiagnosed as another tick-borne disease. This study aimed to direct focus on clinical manifestations of this disease and to examine the role of co-infection with other tick-borne pathogens on its clinical manifestations and laboratory results. An additional aim was to compare the obtained results with previous analysis performed on 120 patients.

METHODS

A retrospective clinical evaluation was conducted for all patients based on data extracted from their medical records. Each patient was assessed by the same team of physicians with extensive expertise in tick-borne diseases. The clinical assessment included a detailed history focused on key epidemiological and exposure-related factors. Patients had laboratory tests performed and all of them also had polymerase chain reaction tests to confirm infection. Overall, 22 patients with anaplasmosis were qualified.

RESULTS

This study presents symptoms that can differentiate patients with HGA mono-infection and co-infected group with significantly elevated aspartate aminotransferase observed in the mono-infection group.

CONCLUSION

Including anaplasmosis in the differential diagnosis is essential in travel medicine, particularly in febrile patients with cytopenias following travel to endemic or rural areas. A thorough diagnostic approach-integrating epidemiological history, clinical manifestations (such as fever, cytopenias, transaminase elevation, especially elevated aspartate aminotransferase levels after excluding non-infectious causes), targeted laboratory investigations, and confirmatory polymerase chain reaction testing-is critical for timely and accurate identification of HGA.