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Volume 25, Number 5—May 2019

Value of PCR, Serology, and Blood Smears for Human Granulocytic Anaplasmosis Diagnosis, France

Yves HansmannComments to Author , Benoit Jaulhac, Pierre Kieffer, Martin Martinot, Elisabeth Wurtz, Régis Dukic, Geneviève Boess, André Michel, Christophe Strady, Jean François Sagez, Nicolas Lefebvre, Emilie Talagrand-Reboul, Xavier Argemi, and Sylvie De Martino
Author affiliations: Université de Strasbourg, Strasbourg, France (Y. Hansmann, B. Jaulhac, E. Talagrand-Reboul, S. De Martino); Hôpitaux Universitaires de Strasbourg, Strasbourg (Y. Hansmann, N. Lefebvre, X. Argemi); Centre National de Référence des Borrelia, Strasbourg (B. Jaulhac, S. De Martino); Centre Hospitalier Emile Muller, Mulhouse, France (P. Kieffer); Centre Hospitalier Pasteur, Colmar, France (M. Martinot); Centre Hospitalier Saverne, Saverne, France (E. Wurtz); Centre Hospitalier de Haguenau, Haguenau, France (R. Dukic); Centre Hospitalier de Guebwiller, Guebwiller, France (G. Boess); Centre Hospitalier de Wissembourg, Wissembourg, France (A. Michel); Polyclinique Saint André, Reims, France (C. Strady); Centre Hospitalier Sélestat, Sélestat, France (J.F. Sagez)

Main Article


Anaplasma phagocytophilum diagnostic test results of patients with nonanaplasmosis and human granulocytic anaplasmosis diagnoses, France, May 2010–July 2012

Test result Control group, no./total Anaplasma group, no./total
Positive blood smear
Positive by serology 2/36 16/19
Seroconversion* or 4-fold rise
in antibody titer 1/36† 6/19‡§
Antibody titer >1:256 at first
Positive PCR 0/36 14/19

*Seroconversion is defined as a change in antibody titer from negative in the first sample obtained during acute illness to >1/64 in the second sample acquired >4 weeks later.
†One patient had a seroconversion with a microbiologically confirmed diagnosis of parvovirus B19 infection.
‡Only 1 patient had a 4-fold increase in antibody titer, but the titer at the first study visit was already high enough to establish the diagnosis (increase from 1:512 to 1:2,048).
§One patient had a seroconversion with an A. phagocytophilum antibody titer >1:256 at the second visit (patient counted once in both serology categories). All other patients with seroconversion had an antibody titer <1:256.
¶One patient with microbiologically confirmed leptospirosis had an A. phagocytophilum antibody titer of 1:256 at the first visit that decreased to 1:64 at the second visit.

Main Article

Page created: April 17, 2019
Page updated: April 17, 2019
Page reviewed: April 17, 2019
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