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Volume 30, Number 12—December 2024
Dispatch

Heartland Virus Infection in Elderly Patient Initially Suspected of Having Ehrlichiosis, North Carolina, USA

Alexis M. BarbarinComments to Author , Teresa G. Fisher, Michael H. Reiskind, Carl Williams, Bryan N. Ayres, Kristen L. Burkhalter, and William L. Nicholson
Author affiliation: North Carolina Division of Public Health, Raleigh, North Carolina, USA (A.M. Barbarin, T.G. Fisher, C. Williams); North Carolina State University, Raleigh (M.H. Reiskind); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.N. Ayres, W.L. Nicholson); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (K.L. Burkhalter)

Main Article

Table 1

Vectorborne disease testing in case study of Heartland virus infection in elderly patient initially suspected of having ehrlichiosis, North Carolina, USA*

Test, specimen source Specimen collection date Result Reference values
Vectorborne and zoonotic organisms
Ehrlichia chaffeensis IgG, serum 2022 Mar 29 1:512 titer <1:64 titer
Heartland virus real-time RT-PCR, serum 2022 Apr 5 Positive Negative
Bourbon virus real-time RT-PCR, serum 2022 Apr 5 Negative Negative
Bourbon PRNT, serum 2022 Apr 5 <1:10 titer, negative <1:10 titer
Heartland PRNT, serum 2022 Apr 5 <1:10 titer, negative <1:10 titer
Rickettsia rickettsii IgG, serum 2022 Apr 5 1:64 titer <1:128 titer
E. chaffeensis IgG, serum 2022 Apr 5 1:1,024 titer <1:64 titer
R. rickettsii IgG, serum 2022 May 11 1:64 titer <1:128 titer
E. chaffeensis IgG, serum 2022 May 11 1:512 titer <1:64 titer
E. chaffeensis PCR, serum 2022 Mar 29 Negative Negative
Eastern equine encephalitis virus IgM, serum
2022 Apr 2
Negative
Negative
Viruses
Hepatitis A virus IgG, serum 2022 Mar 28 Positive Negative
Hepatitis A virus IgM, serum 2022 Mar 28 Negative Negative
Hepatitis B surface antibody, serum 2022 Mar 28 Negative Negative
Hepatitis B core antibody, serum 2022 Mar 28 Negative Negative
Hepatitis C virus antibody, serum 2022 Mar 28 Negative Negative
Cytomegalovirus IgG, serum 2022 Mar 28 Positive Negative
Cytomegalovirus IgM, serum 2022 Mar 28 Negative Negative
Cytomegalovirus PCR, blood 2022 Apr 1 Negative Negative
Herpes simplex virus 1/2 PCR, serum 2022 Apr 2 Negative Negative
Herpes simplex virus 1 IgG, serum 2022 Apr 2 Positive Negative
Herpes simplex virus 2 IgG, serum 2022 Apr 2 Negative Negative
Epstein-Barr virus PCR, serum 2022 Mar 31 Negative Negative
HIV-1/2 antibody, serum 2022 Mar 29 Negative Negative
HIV-1 p24 antigen, serum 2022 Mar 29 Negative Negative
Sapovirus PCR, feces 2022 Mar 29 Negative Negative
Adenovirus F40/41 PCR, feces 2022 Mar 29 Negative Negative
Astrovirus PCR, feces 2022 Mar 29 Negative Negative
Norovirus PCR, feces 2022 Mar 29 Negative Negative
Rotavirus A PCR, feces 2022 Mar 29 Negative Negative
Respiratory syncytial virus PCR, nasopharyngeal swab 2022 Mar 27 Negative Negative
Influenza A/B PCR, nasopharyngeal swab 2022 Mar 27 Negative Negative
SARS-CoV-2 PCR, nasopharyngeal swab 2022 Mar 27 Negative Negative
Parvovirus IgM, serum
2022 Mar 29
Negative
Negative
Bacteria
Streptococcus pneumoniae antigen, urine 2022 Apr 2 Negative Negative
Legionella pneumophila antigen, urine 2022 Mar 31 Negative Negative
Coxiella burnetii PCR, serum 2022 Apr 2 Negative Negative
Campylobacter PCR, feces 2022 Mar 29 Negative Negative
Plesiomonas shigelloides PCR, feces 2022 Mar 29 Negative Negative
Salmonella PCR, feces 2022 Mar 29 Negative Negative
Vibrio cholerae PCR, feces 2022 Mar 29 Negative Negative
Vibrio PCR, feces 2022 Mar 29 Negative Negative
Yersinia enterocolitica PCR, feces 2022 Mar 29 Negative Negative
Enteroaggregative Escherichia coli PCR, feces 2022 Mar 29 Negative Negative
Enteropathogenic E. coli PCR, feces 2022 Mar 29 Negative Negative
Enterotoxigenic E. coli PCR, feces 2022 Mar 29 Negative Negative
Enteroinvasive E. coli PCR, feces 2022 Mar 29 Negative Negative
Shiga-toxin producing E. coli PCR, feces 2022 Mar 29 Negative Negative
Clostridioides difficile PCR, feces 2022 Mar 29 Negative Negative
Francisella tularensis, serum 2022 Apr 2 Negative Negative
Culture, blood
2022 Apr 5
No growth
No growth
Parasites
Cryptosporidium PCR, feces 2022 Mar 29 Negative Negative
Cryptosporidium cayetanensis PCR, feces 2022 Mar 29 Negative Negative
Entamoeba histolytica PCR, feces 2022 Mar 29 Negative Negative
Giardia lamblia PCR, feces 2022 Mar 29 Negative Negative
Parasite smear, feces 2022 Mar 31 Negative Negative
Toxoplasma IgM/IgG, serum 2022 Apr 2 Negative Negative

*Bold text indicates positive acute test result. PRNT, plaque reduction neutralization test; RT-PCR, reverse transcription PCR.

Main Article

Page created: October 15, 2024
Page updated: November 26, 2024
Page reviewed: November 26, 2024
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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