{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:43:39Z","timestamp":1792827819069,"version":"4.5.0"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n \n Human granulocytotropic anaplasmosis (HGA), caused by\n \n Anaplasma phagocytophilum,<\/jats:italic>\n <\/jats:italic>\n and human monocytotropic ehrlichiosis (HME), caused by\n \n Ehrlichia chaffeensis<\/jats:italic>\n <\/jats:italic>\n , are tick-borne zoonoses. The vast majority of\n \n Anaplasma phagocytophilum<\/jats:italic>\n <\/jats:italic>\n infections reported worldwide are from the United States.\n \n Ehrlichia chaffeensis<\/jats:italic>\n <\/jats:italic>\n infections are reported exclusively from North America, with the majority reported from the United States. We have recently summarized the available data on HGA and HME in the form of two systematic reviews. We compared data from these two systematic reviews to objectify differences in epidemiological and clinical presentation between the two diseases in the United States.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n From our recently published systematic reviews on HGA and HME, \u00abbest evidence data\u00bb were extracted and comparatively analyzed. Cases were included if (i) they had a high level of diagnostic certainty (i.e., diagnosed by PCR, culture, immunostaining of tissue, or paired IgG IFA serology), (ii) individual clinical data were available, (iii) no concomitantly present coinfection(s) were reported, and (iv) the infection was acquired in the United States.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n HME cases were statistically more frequent immunocompromised and younger and had gastrointestinal symptoms, hepatosplenomegaly and elevated liver function tests (LFT) levels. HGA cases were statistically more frequent presenting with pulmonary symptoms and encephalitis. Hospitalization and a fatal outcome was more frequent in HME. No differences in fatal outcome were observed between immunocompetent and immunocompromised HME cases.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Although HGA and HME show similarities, there are statistically significant differences in terms of their clinical patterns and outcomes and a not yet described difference in the affected age pattern.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0334957","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T18:22:20Z","timestamp":1762885340000},"page":"e0334957","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of the epidemiological and clinical fingerprints of Human Granulocytotropic Anaplasmosis and Human Monocytotropic Ehrlichiosis in the United States"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4026-9760","authenticated-orcid":true,"given":"Christian","family":"Kositz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Gygax","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Schudel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Kuenzli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Neumayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"issue":"7","key":"pone.0334957.ref001","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.3390\/microorganisms10071433","article-title":"Human Granulocytic Anaplasmosis-A Systematic Review of Published Cases","volume":"10","author":"I Dumic","year":"2022","journal-title":"Microorganisms"},{"issue":"8","key":"pone.0334957.ref002","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012313","article-title":"Human granulocytotropic anaplasmosis-A systematic review and analysis of the literature","volume":"18","author":"S Schudel","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pone.0334957.ref003","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.cll.2009.10.004","article-title":"Human ehrlichiosis and anaplasmosis","volume":"30","author":"N Ismail","year":"2010","journal-title":"Clin Lab Med"},{"key":"pone.0334957.ref004","first-page":"100830","article-title":"Worldwide meta-analysis on Anaplasma phagocytophilum infections in animal reservoirs: Prevalence, distribution and reservoir diversity","volume":"38","author":"SN Karshima","year":"2023","journal-title":"Vet Parasitol Reg Stud Reports"},{"issue":"7","key":"pone.0334957.ref005","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1089\/vbz.2019.2595","article-title":"Increased Incidence of Ehrlichia chaffeensis Infections in the United States, 2012 Through 2016","volume":"20","author":"M Mogg","year":"2020","journal-title":"Vector Borne Zoonotic Dis"},{"issue":"1","key":"pone.0334957.ref006","doi-asserted-by":"crossref","first-page":"52","DOI":"10.4269\/ajtmh.15-0540","article-title":"Increasing Incidence of Ehrlichiosis in the United States: A Summary of National Surveillance of Ehrlichia chaffeensis and Ehrlichia ewingii Infections in the United States, 2008\u20132012","volume":"94","author":"KN Heitman","year":"2016","journal-title":"Am J Trop Med Hyg"},{"issue":"11","key":"pone.0334957.ref007","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1089\/vbz.2019.2598","article-title":"Increasing Incidence of Anaplasmosis in the United States, 2012 Through 2016","volume":"20","author":"A Baker","year":"2020","journal-title":"Vector Borne Zoonotic Dis"},{"key":"pone.0334957.ref008","unstructured":"CDC. 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Epidemiology and Statistics. https:\/\/www.cdc.gov\/anaplasmosis\/hcp\/statistics\/index.html. 2024 November 3."},{"issue":"2","key":"pone.0334957.ref010","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/MD.0b013e318168da1d","article-title":"The importance of early treatment with doxycycline in human ehrlichiosis","volume":"87","author":"BJ Hamburg","year":"2008","journal-title":"Medicine (Baltimore)"},{"issue":"8","key":"pone.0334957.ref011","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012377","article-title":"Human monocytotropic ehrlichiosis-A systematic review and analysis of the literature","volume":"18","author":"L Gygax","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pone.0334957.ref012","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4269\/ajtmh.15-0122","article-title":"Human granulocytic anaplasmosis in the United States from 2008 to 2012: a summary of national surveillance data","volume":"93","author":"FS Dahlgren","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0334957.ref013","article-title":"Trends in Anaplasmosis Over the Past Decade: A Review of Clinical Features, Laboratory Data and Outcomes","author":"S Katragadda","year":"2025","journal-title":"Clin Infect Dis"},{"issue":"3","key":"pone.0334957.ref014","doi-asserted-by":"crossref","first-page":"116484","DOI":"10.1016\/j.diagmicrobio.2024.116484","article-title":"Ehrlichiosis and anaplasmosis in solid organ transplantation: A case series and review of the literature","volume":"110","author":"TL Jang","year":"2024","journal-title":"Diagn Microbiol Infect Dis"},{"key":"pone.0334957.ref015","article-title":"Mandell, Douglas, and Bennett\u2019s principles and practice of infectious diseases, chapter 194: Ehrlichia chaffeensis (human monocytotropic ehrlichosis), Anaplasma phagocytophilum (human granulocytic anaplasmosis), and other Anaplasmataceae.","author":"JB Blaser","year":"2019","edition":"9"},{"issue":"2","key":"pone.0334957.ref016","doi-asserted-by":"crossref","first-page":"154","DOI":"10.3390\/idr16020012","article-title":"Hemophagocytic Lymphohistiocytosis (HLH) in Patients with Tick-Borne Illness: A Scoping Review of 98 Cases","volume":"16","author":"D Jevtic","year":"2024","journal-title":"Infect Dis Rep"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0334957","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T18:22:31Z","timestamp":1762885351000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0334957"}},"subtitle":[],"editor":[{"given":"Yong","family":"Qi,","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0334957","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]}}}