# Pulmonary Embolism as a Rare Complication of Anaplasmosis: A Case Report

**Authors:** Nabil Varwani, Arshia Ahmed, Salman J Khan, Lela Adeoshun

PMC · DOI: 10.7759/cureus.102307 · Cureus · 2026-01-26

## TL;DR

A rare case of pulmonary embolism in a patient with anaplasmosis is reported, highlighting diagnostic challenges with antiphospholipid antibodies during infection.

## Contribution

This case report presents a rare complication of anaplasmosis and discusses diagnostic challenges with antiphospholipid antibody testing during acute infection.

## Key findings

- A 69-year-old man with anaplasmosis developed bilateral pulmonary emboli and pneumonia despite doxycycline treatment.
- Positive antiphospholipid antibodies were found, but their significance was unclear due to acute infection and anticoagulation.
- The case emphasizes the need to consider venous thromboembolism in anaplasmosis patients with chest pain or respiratory symptoms.

## Abstract

Pulmonary embolism is an exceptionally rare complication of anaplasmosis. We report a case of a 69-year-old man with acute Anaplasma phagocytophilum infection who developed bilateral pulmonary emboli and pneumonia despite appropriate doxycycline therapy. Evaluation revealed positive antiphospholipid antibodies, raising concern for antiphospholipid syndrome; however, interpretation was confounded by acute infection and ongoing anticoagulation, limiting the ability to distinguish transient infection-associated antibody positivity from an underlying thrombophilic disorder. This case highlights the need to consider venous thromboembolism in patients with anaplasmosis presenting with chest pain or respiratory symptoms and underscores the diagnostic uncertainty surrounding antiphospholipid antibody testing in the setting of acute infection and thrombosis.

## Linked entities

- **Chemicals:** doxycycline (PubChem CID 54671203)
- **Diseases:** pulmonary embolism (MONDO:0005279), anaplasmosis (MONDO:0005118), pneumonia (MONDO:0005249), antiphospholipid syndrome (MONDO:0017278)

## Full-text entities

- **Genes:** PROC (protein C, inactivator of coagulation factors Va and VIIIa) [NCBI Gene 5624] {aka APC, PC, PROC1, THPH3, THPH4}, GPT (glutamic--pyruvic transaminase) [NCBI Gene 2875] {aka AAT1, ALT, ALT1, GPT1, SGPT}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, SLC17A5 (solute carrier family 17 member 5) [NCBI Gene 26503] {aka AST, ISSD, NSD, SD, SIALIN, SIASD}, SERPINC1 (serpin family C member 1) [NCBI Gene 462] {aka AT3, AT3D, ATIII, ATIII-R2, ATIII-T1, ATIII-T2}, F2 (coagulation factor II, thrombin) [NCBI Gene 2147] {aka PT, RPRGL2, THPH1}
- **Diseases:** shock (MESH:D012769), trauma (MESH:D014947), tick bite (MESH:D064927), headache (MESH:D006261), inflammation (MESH:D007249), nephrolithiasis (MESH:D053040), Pulmonary involvement (MESH:C566343), clotting disorders (MESH:D020141), pain (MESH:D010146), arterial thrombosis (MESH:D002341), renal failure (MESH:D051437), pituitary tumor (MESH:D010911), acquired (MESH:D003638), dyspnea (MESH:D004417), ischemic (MESH:D002545), pancytopenia (MESH:D010198), cancer (MESH:D009369), borne (MESH:D017282), edema (MESH:D004487), Lyme disease (MESH:D008193), leukopenia (MESH:D007970), pleural effusion (MESH:D010996), organ failure (MESH:D009102), autoimmune disease (MESH:D001327), bleeding (MESH:D006470), skin cancer (MESH:D012878), tachycardia (MESH:D013610), infiltrates (MESH:D017254), chest pain (MESH:D002637), hypercoagulable (MESH:D019851), bacterial pneumonia (MESH:D018410), Anaplasma phagocytophilum infection (MESH:D000712), bibasilar pneumonia (MESH:D011014), hemoptysis (MESH:D006469), vitamin D deficiency (MESH:D014808), primary hyperparathyroidism (MESH:D049950), acute infection (MESH:D000208), pulmonary emboli (MESH:D020766), fever (MESH:D005334), acute respiratory distress syndrome (MESH:D012128), Pulmonary Embolism (MESH:D011655), tick (MESH:D013985), aortic valve sclerosis (MESH:D000082862), lupus anticoagulant (MESH:C531622), Thrombotic (MESH:D013927), VTE (MESH:D054556), Infections (MESH:D007239), hernia (MESH:D006547), coagulation disorders (MESH:D001778), thrombocytopenia (MESH:D013921), cerebral infarction (MESH:D002544), cough (MESH:D003371), APS (MESH:D016736), renal calculi (MESH:D007669), leukocytosis (MESH:D007964), tricuspid regurgitation (MESH:D014262), Costovertebral angle (CVA) tenderness (MESH:D063806), liver dysfunction (MESH:D017093), ovarian cancer (MESH:D010051), erythema (MESH:D004890)
- **Chemicals:** doxycycline (MESH:D004318), oxygen (MESH:D010100), Lactate (MESH:D019344), Antiphosphatidylserine (-), ceftriaxone (MESH:D002443), Rivaroxaban (MESH:D000069552), Warfarin (MESH:D014859), heparin (MESH:D006493)
- **Species:** Anaplasma phagocytophilum (agent of human granulocytic ehrlichiosis, species) [taxon 948], Homo sapiens (human, species) [taxon 9606], Ixodes (genus) [taxon 6944]
- **Mutations:** G20210A

## Full text

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## Figures

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## References

14 references — full list in the complete paper: https://tomesphere.com/paper/PMC12933371/full.md

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Source: https://tomesphere.com/paper/PMC12933371