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Case Reports
. 2021 Jun 15;21(1):579.
doi: 10.1186/s12879-021-06297-z.

Case report: first symptomatic Candidatus Neoehrlichia mikurensis infection in Slovenia

Mitja Lenart  1 , Miha Simoniti  2 , Katja Strašek-Smrdel  3 , Vesna Cvitković Špik  3 , Tanja Selič-Kurinčič  2 , Tatjana Avšič-Županc  3
Affiliations
Case Reports

Case report: first symptomatic Candidatus Neoehrlichia mikurensis infection in Slovenia

Mitja Lenart et al. BMC Infect Dis. .

Abstract

Background: Candidatus Neoehrlichia mikurensis (CNM) is an emerging tick-born pathogen and usually causes symptomatic infection only in immunocompromised patients. Apart from one described case found in the literature where cultivation was successful, all cases so far were diagnosed by using broad-range 16S rDNA PCR.

Case presentation: Our patient presented with a prolonged febrile state of unknown origin. Clinical presentation, extensive medical workup and classic microbiologic testing were non-conclusive. Several infectious agents and other causes for the febrile state were excluded. In the end, a broad-range 16S rDNA PCR was to be performed to confirm the diagnosis of CNM infection. Treatment was successful with doxycycline.

Conclusions: Due to the obscurity of the pathogen, diagnostic workup in CNM is prolonged and challenging. More awareness is need about this emerging infectious disease in countries with high prevalence of tick-borne diseases as standard microbiological methods are not successful in confirming the diagnosis.

Keywords: 16S rRNA PCR; Candidatus Neoehrlichia mikurensis; Fever of unknown origin; Immunocompromised; Infection; Tick.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this article.

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