Anaplasma phagocytophilum

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Very rare
Time to detection: 
10 days
Alerting signals, symptoms, evidence of occurrence: 
Sudden onset of fever with elevated C-reactive protein, mild liver function test elevations 10 days post transfusion; she was started on broad spectrum antibiotics. Patient condition worsened with fever, tachypnea, hypotension and she was transferred to the intensive care unit, with change in antibiotic regimen. Fever and thrombocytopenia continued and patient developed ARDS; Human granulocytic anaplasmosis was suspected, doxycycline was added to antibiotic regimen and patient began recovering clinically on day 3 of doxycycline.
Demonstration of imputability or root cause: 
Diagnosis in recipient was confirmed with bone marrow evaluation with evidence morula; A. phagocytophilum DNA was found in plasma and bone marrow. A. Phagocytophilum DNA was confirmed in the stored plasma of one of six donors. The recipient had no tick exposure and in fact was hospitalized for the month preceding the onset of her symptoms.
Imputability grade: 
3 Definite/Certain/Proven
Suggest new keywords: 
Human Granulocytic Anaplasmosis, Anaplasma phagocytophilum infection
Reference attachment: 
Suggest references: 
Severe human granulocytic anaplasmosis transmitted by blood transfusion. Jareb M et al. Emerg Infect Dis. 18(8):1354-7, 2012 Aug.
Expert comments for publication: 
Rare case of post transfusion human granulocytic anaplasmosis (HGA) following a cesarean section. The recipient and donor were both confirmed to have A. phagocytophilum DNA in plasma; the recipient had evidence for morula and A. phagocytophilum DNA in her bone marrow as well.