Borreliosis And Human Granulocytic Anaplasmosis Coinfection With Positive Rheumatoid Factor And Monospot Test: Case-Report

摘要

We are reporting a case of co-infection with B.burgdorferi and A.phagocytophila with unusual clinical and lab results.A 36-year-old Caucasian man from Warner Robins, GA, an engineer, presented with a two-week history of febrile illness up to 103 F, severe headaches, fear of light, body aches, irritability, weakness and night sweats. This started two weeks after a 5-days trip to Panama City, Florida, where he had to work outdoors. Physical exam yielded no specific signs. Ultrasound showed hepatomegaly. Laboratory studies revealed elevated liver enzymes, B.burgdorferi IgM 3.7 index, A.phagocytophila IgM ≥1:1280, rheumatoid factor, atypical lymphocytes and positive monospot test.Patients who have been diagnosed with one tick-borne infection are at an increased risk and should be tested for other related infections. Rheumatoid factor and monospot test may be falsely positive in such cases.