• Anaplasmosis
• Ehrlichiosis
• Metagenomics
• Microbial cell-free DNA (mcfDNA) sequencing
• Serology
• Solid organ transplant
• Tick-borne infections

• Humans
• Anaplasmosis/diagnosis
• Anaplasmosis/microbiology
• Ehrlichiosis/diagnosis
• Ehrlichiosis/drug therapy
• Ehrlichiosis/microbiology
• Male
• Middle Aged
• Female
• Organ Transplantation/adverse effects
• Adult
• Aged
• DNA, Bacterial/genetics
• Transplant Recipients

• Humans
• Ehrlichiosis/epidemiology
• Ehrlichiosis/drug therapy
• Ehrlichiosis/complications
• Ehrlichiosis/microbiology
• Ehrlichiosis/diagnosis
• Ehrlichia chaffeensis
• Immunocompromised Host
• Animals

In recent solid organ transplant recipients, acute febrile illness is usually a source of grave concern and a diagnostic dilemma, especially if no response is noted after initiation of broad antimicrobial therapy. Human Monocytic Ehrlichiosis (HME) is a tick-borne illness caused by Ehrlichia chaffeensis and is not considered an opportunistic infection in immunocompromised patients such as solid organ transplant patients. Ehrlichiosis in immunocompromised patients can be life-threatening, and a strong index of suspicion is needed, especially in patients who live in endemic areas, for proper treatment initiation with doxycycline. We report a case of a 40-year-old male who received an orthotopic liver transplant six months earlier secondary to primary sclerosing cholangitis, on chronic immunosuppressive medication, who presented with complaints of sudden onset fever associated with nausea, vomiting, and diarrhea. Initial extensive infectious workup was negative and no response to empiric antimicrobials. There was suspicion for ehrlichiosis prompting empiric doxycycline use. Subsequently, E. chaffeensis polymerase chain reaction (PCR) was positive, and the antibiotic regimen was de-escalated to only doxycycline with complete resolution of his symptoms and progressive improvement in previously abnormal biochemical indices.

Anaplasmosis and ehrlichiosis are tick-borne diseases affecting humans and livestock, particularly in tropical and subtropical regions. Animal husbandry is the main activity of people on the borders of Iran and Pakistan, with thousands of cattle crossing the border each week.

PCR and sequencing of the 16S rRNA gene was used to determine the percentage and geographical distribution of the pathogens carried by Hyalomma spp. (n = 306) collected from 126 goats, cattle and camels in the region between November 2017 and late March 2018.

In total, 1124 hard ticks including 1020 Hyalomma spp. ticks belonging to six species (Hyalomma anatolicum, Hyalomma asiaticum, Hyalomma marginatum, Hyalomma dromedarii, Hyalomma schulzei, and Hyalomma detritum) were found on the borders of Iran and Pakistan, with H. anatolicum being the most prevalent tick species. Anaplasma spp. and/or Ehrlichia spp. DNA was found in 68.3% of the engorged tick specimens (n = 256). Sequencing of a subset (12.6%) of PCR-positive samples revealed Anaplasma ovis, Anaplasma marginale, and Ehrlichia ewingii DNA in 81.8%, 9.1%, and 9.1% of the ticks, respectively. To our knowledge, this is the first report of E. ewingii, an important human pathogen, in Iran.

Based on molecular analysis, three pathogenic Anaplasmataceae were detected in six Hyalomma spp. parasitizing cattle, goats and camels, confirming the presence of these pathogens along the Iran-Pakistan border.

The online version contains supplementary material available at 10.1186/s13071-021-04956-3.

• Anaplasmosis
• Ehrlichiosis
• Hard ticks
• Iran
• Pakistan
• Tick-borne diseases

In India, infectious diseases are a leading treatable cause of morbidity and mortality. Mangalore being endemic to many vector‐borne diseases, their incidence is known to show seasonal variations with sharp increase during monsoon. Leucocytes have substantial role in the immunological pathogenesis of infections.

The present series was a hospital‐based cross‐sectional study performed in a tertiary care hospital for a period of three months from June‐August wherein the cell population data of cases of malaria, dengue, leptospirosis, typhoid and rickettsial infections along with equal number of healthy controls were collected and analysed. Effectiveness of leucocyte‐related volume (V), conductivity (C) and scatter (S) parameters by Coulter®DXH800 haematology analyser in predicting these infections was appraised.

A total of 324 cases comprising of malaria (50%), dengue (30.9%), leptospirosis (13.9%), typhoid (4.0%) and rickettsial infections (1.2%) were included. There was statistically significant differences (P < 0.05) in the mean values of complete blood count parameters—haemoglobin, total leucocyte count, red blood cell count, haematocrit, red cell distribution width, differential leucocyte count, platelet count and plateletcrit between cases and controls and also between specific infections. The mean volumes of neutrophil, monocyte and lymphocyte were considerably increased in malaria and dengue fever compared to leptospirosis, typhoid and rickettsial infections. VCS parameters were the least altered in typhoid fever, except for a strikingly high conductivity and scatter of eosinophils.

Haematological analysis is a part of routine evaluation of any case of febrile illness. This study showed that there are specific alterations in VCS parameters in different types of infections such as malaria, dengue, leptospira, typhoid and rickettsia, the information and analysis of which comes without any additional cost.

• cell population data
• mean neutrophil volume
• tropical
• vector-borne
• volume-conductivity-scatter data

• Centers for Disease Control and Prevention (CDC)
• National Notifiable Diseases Surveillance System (NNDSS)
• human ehrlichiosis
• incidence rate
• spatial epidemiology

• Ehrlichia chaffeensis
• Ehrlichiosis/epidemiology
• Humans
• Incidence
• Population Surveillance
• Time Factors
• United States/epidemiology

• Ehrlichiosis
• kidney transplantation
• solid organ transplants
• tick exposure

• Bacteria
• Non-vector borne diseases
• Parasites
• Solid-organ transplant
• Vector-borne diseases
• Viruses
• Zoonoses

• Ehrlichia
• South Africa
• livestock
• public health
• ticks
• zoonosis

• bacterial species
• hemotropic mycoplasma
• perinatal
• rickettsia
• vector-borne

• Animals
• Dogs
• Female
• Pregnancy
• Antibodies, Bacterial
• Coinfection/veterinary
• Dog Diseases/microbiology
• Dog Diseases/transmission
• Ehrlichia/isolation & purification
• Ehrlichiosis/immunology
• Ehrlichiosis/veterinary
• Infectious Disease Transmission, Vertical/veterinary
• Mycoplasma/isolation & purification
• Mycoplasma Infections/transmission
• Mycoplasma Infections/veterinary

• T32 OD011130 NIH HHS
• North Carolina State University
• T32OD011130 National Institutes of Health Comparative Medicine and Translational Research Program

Ehrlichia ewingii is the most seroprevalent Ehrlichia‐infecting dogs in the southern and mid‐western United States. Fever, lameness, and polyarthritis are commonly reported findings in dogs naturally infected with E. ewingii.

To evaluate clinicopathologic findings in a population of dogs naturally infected with E. ewingii.

Forty‐one dogs PCR positive for E. ewingii and PCR negative for other targeted vector‐borne organisms.

Retrospective study. Clinical and clinicopathologic data including physical examination findings, CBC, serum biochemistry, urinalysis (UA), symmetric dimethylarginine (SDMA), and vector‐borne disease diagnostic results were reviewed.

Frequent clinical diagnoses other than ehrlichiosis (28/41; 68.3%) were renal disease (7/41; 17.1%) and immune‐mediated hemolytic anemia (IMHA) (6/41; 14.6%). The most frequent physical examination finding was joint pain (14/41; 34.1%). Prominent hematologic and biochemical abnormalities included abnormal lymphocyte counts (22/36; 61.1%); neutrophilia (21/37; 56.8%); increased alkaline phosphatase (20/35; 57.1%) and alanine transaminase (14/35; 40%) activities; and increased SDMA concentration (11/34; 32.4%). Urinalysis abnormalities included proteinuria (20/27; 74%), most with inactive sediments (16/20; 80%). Dogs were seroreactive by Ehrlichia canis immunofluorescence assay (IFA; 17/39; 43.6%) and Ehrlichia ELISA (34/41; 82.9%). Seroreactivity by IFA for other vector‐borne pathogens included Bartonella (1/39; 2.6%), Rickettsia rickettsii (spotted‐fever group rickettsiae) (12/39; 30.8%), and Borrelia burgdorferi by ELISA (1/41; 2.4%).

Renal disease, IMHA, proteinuria, neutrophilia, abnormal lymphocytes, and increased liver enzyme activities were common in this group of E. ewingii‐infected dogs. Studies are needed to determine if E. ewingii contributes to comorbidities or is a precipitating factor in clinical syndromes in persistently infected dogs.

• canine
• granulocytic ehrlichiosis
• tick-borne