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Volume 11, Number 12—December 2005

Perspective

Human Granulocytic Anaplasmosis and Anaplasma phagocytophilum

J. Stephen Dumler*Comments to Author , Kyoung-Seong Choi*, Jose Carlos Garcia-Garcia*, Nicole S. Barat*, Diana G. Scorpio*, Justin W. Garyu*, Dennis J. Grab*, and Johan S. Bakken†‡
Author affiliations: *Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; †University of Minnesota at Duluth, Duluth, Minnesota, USA; ‡St. Luke's Hospital, Duluth, Minnesota, USA

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Table

Metaanalysis of clinical manifestations and laboratory abnormalities in patients with human granulocytic anaplasmosis*

Characteristics All
 North America
 Europe
Median %† Mean % n‡ Mean % n Mean % n
Symptom or sign
Fever 100 92 480 92 448 98 66
Myalgia 74 77 514 79 448 65 66
Headache 89 75 378 73 289 89 66
Malaise 93 94 90 96 271 47 15
Nausea 44 38 256 36 207 47 49
Vomiting 20 26 90 34 41 19 49
Diarrhea 13 16 90 22 41 10 49
Cough 13 19 260 22 207 10 49
Arthralgias 58 46 497 47 448 37 49
Rash 3 6 685 6 289 4 53
Stiff neck 11 18 22 22 18 0 4
Confusion 9 17 211 17 207 0 4
Laboratory abnormality
Leukopenia 38 49 329 50 282 47 47
Thrombocytopenia 71 71 329 72 282 64 47
Elevated serum AST or ALT§ 74 71 170 79 123 51 47
Elevated serum creatinine 15 43 72 49 59 0 13

*Data from references 5, 6, 8–15.

†Median percentage of patients with feature among all reports.

‡Number of patients with data available for metaanalysis.

§AST, aspartate aminotransferase; ALT, alanine aminotransferase.

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