A Case of Human Granulocytic Anaplasmosis Suspected to be Complicated by Cholangitis

Human granulocytic anaplasmosis is a febrile illness caused by Anaplasma phagocytophilum, an intracellular bacterium transmitted ticks that mainly prevalent in the United States and Europe. Five cases have been reported from Japan. A 63-year-old man was admitted to our hospital with 5-day history of high fever. The patient frequently worked mountainous areas having felt insect bite or thorn stick his right leg some days earlier. Laboratory investigations showed increased serum levels C-reactive protein, total bilirubin hepatobiliary enzymes. immediately started on treatment received minocycline 200 mg/day for 8 ceftriaxone sodium 2 g/day 6 suspected diagnosis rickettsiosis acute cholangitis, recovered eight days. Eventually, basis results tests antibodies tick-borne pathogens, which revealed increase antibody titers A. phagocytophilum paired sera, diagnosed as anaplasmosis. Different 5 previously Japan, this habitual drinker cholangitis complication him. Herein, we report unusual presentation severe disease complications human drinker.