Case report: first symptomatic Candidatus Neoehrlichia mikurensis infection in Slovenia

BackgroundCandidatus 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 presentationOur 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.ConclusionsDue 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.

Automated summary

Diagnosis of CNM is challenging and prolonged due to the obscurity of the pathogen. There is a need for more awareness about this emerging infectious disease, especially in countries with high prevalence of tick-borne diseases, as standard microbiological methods may not be successful in confirming the diagnosis. Successful treatment with doxycycline was achieved in this case.