# Becoming Endemic: Anaplasmosis Imported Across State Borders

## TL;DR

An elderly woman in Ohio was diagnosed with tick-borne anaplasmosis after showing symptoms following outdoor exposure in Pennsylvania.

## Contribution

This case highlights the importance of early recognition of human granulocytic anaplasmosis for better patient outcomes.

## Key findings

- The patient showed rapid symptom resolution after treatment for HGA.
- Early recognition of HGA can reduce unnecessary treatments.
- Clinical presentation included leukopenia, thrombocytopenia, and elevated liver enzymes.

## Abstract

Anaplasma phagocytophilum is the causative agent of human granulocytic anaplasmosis (HGA), a tick-borne illness with increasing incidence since being described in the 1990s. Importantly, the presentation can be vague, yet prompt treatment is paramount. An 81-year-old Caucasian female was hospitalized in Cincinnati, Ohio, for fever and confusion following prolonged outdoor exposure in Emlenton, Pennsylvania. She initially was treated for sepsis from presumed community-acquired pneumonia; however, the combination of leukopenia, thrombocytopenia, and elevated liver enzymes prompted empiric tick-borne illness consideration and treatment with rapid resolution in symptoms. Early recognition of HGA can reduce unnecessary treatments and improve patient outcomes.