Methods: A retrospective chart review was performed in all patients with ICD-9 or ICD-10 diagnostic codes for Ehrlichiosis or Anaplasmosis between 2014 and 2016 at Southampton Hospital (a major community hospital for the rural east end of Suffolk County, Long Island, NY) and Stony Brook University Hospital (the only tertiary medical center in Suffolk County). Inclusion criteria consisted of a positive blood PCR for either Anaplasma phagocytophilum or Ehrlichia spp. (chaffeensis, canis, muris-like or ewingii). Demographics, clinical and laboratory variables were collected and compared to distinguish characteristics of these two different infections. Cases with 3 or more previously defined markers of severe disease [acute kidney injury (AKI), leukopenia, thrombocytopenia, elevated transaminases] were defined as severe cases.
Results: A total of 15 cases of Ehrlichiosis (E, mean age: 72.1 ±12.6) and 11 cases of Anaplasmosis (A, mean age: 63.8 ±13.5) were compared. Clinical presentation was similar with the two most common symptoms: fever (E 86.7%, A 90.9%) and fatigue (E 80.0%, A 72.7%). Average length of stay for hospitalized patients was 3.07 (E) and 2.91 (A, p=.58) days, respectively. Leukopenia (E 93.3%, A 63.6%; p =0.06), thrombocytopenia (E 100%, A 81.8%; p =0.09), AKI (E 53.3%, A 18.2%; p =0.07) and transaminitis (E 46.7%, A 27.3%; p =0.32) was more common for Ehrlichiosis. Severe cases were observed significantly more with Ehrlichiosis than Anaplasmosis (E 73.3% vs A 27.3%, p = 0.02).
Conclusion: Ehrlichiosis and Anaplasmosis had similar clinical presentations while laboratory data was more severe for Ehrlichiosis in cases from an endemic area in the Northeast of the U.S.
M. Haktanir Abdul, None
L. A. Marcos, None