Anaplasma phagocytophilum is the agent of tick-borne fever, equine, canine and human granulocytic anaplasmosis. The common route of A. phagocytophilum transmission is through a tick bite, the main vector in Europe being Ixodes ricinus. Despite the apparently ubiquitous presence of the pathogen A. phagocytophilum in ticks and various wild and domestic animals from Europe, up to date published clinical cases of human granulocytic anaplasmosis (HGA) remain rare compared to the worldwide status. It is unclear if this reflects the epidemiological dynamics of the human infection in Europe or if the disease is underdiagnosed or underreported. Epidemiologic studies in Europe have suggested an increased occupational risk of infection for forestry workers, hunters, veterinarians, and farmers with a tick-bite history and living in endemic areas. Although the overall genetic diversity of A. phagocytophilum in Europe is higher than in the USA, the strains responsible for the human infections are related on both continents. However, the study of the genetic variability and assessment of the difference of pathogenicity and infectivity between strains to various hosts has been insufficiently explored to date. Most of the European HGA cases presented as a mild infection, common clinical signs being pyrexia, headache, myalgia and arthralgia. The diagnosis of HGA in the USA was recommended to be based on clinical signs and the patient's history and later confirmed using specialized laboratory tests. However, in Europe since the majority of cases are presenting as mild infection, laboratory tests may be performed before the treatment in order to avoid antibiotic overuse. The drug of choice for HGA is doxycycline and because of potential for serious complication the treatment should be instituted on clinical suspicion alone.

中文翻译：

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欧洲人类粒细胞无形体病及其病原体的生态流行病学和临床管理综述。

吞噬细胞无浆膜是tick传热，马，犬和人类粒细胞无性病的病原体。嗜食曲霉的常见传播途径是通过tick叮咬，在欧洲，主要传播媒介是蓖麻（Ixodes ricinus）。尽管欧洲的壁虱和各种野生和家养动物中均普遍存在病原体嗜食性链球菌，但与世界范围内的状况相比，迄今已公布的人类粒细胞无丝虫病（HGA）临床病例仍然很少。目前尚不清楚这是否反映了欧洲人类感染的流行病学动态，还是该疾病的诊断或报告不足。欧洲的流行病学研究表明，有for虫病史并居住在流行地区的林业工人，猎人，兽医和农民，其职业感染风险增加。尽管在欧洲，吞噬链球菌的总体遗传多样性高于美国，但造成人类感染的菌株在两大洲都有关系。然而，迄今为止，关于各种宿主的菌株之间的遗传变异性和致病性和感染性差异评估的研究还不够充分。大多数欧洲HGA病例表现为轻度感染，常见的临床体征为发热，头痛，肌痛和关节痛。建议在美国根据临床体征和患者病史对HGA进行诊断，随后再通过专门的实验室检查进行确诊。但是，在欧洲，由于大多数病例都表现为轻度感染，因此在治疗前可能要进行实验室检查，以免抗生素过度使用。