Can Anaplasmosis Cause Heart Problems and Cardiac Complications?
Heart complications from anaplasmosis are uncommon but possible
Tick-borne infections may overlap and complicate diagnosis
Early recognition may reduce serious outcomes
Over the last several years, there has been a three-fold increase in anaplasmosis cases in the United States. Although most people develop flu-like symptoms, anaplasmosis complications can occasionally involve the heart, leading to myocarditis, carditis, and other serious cardiac complications.
The tick-borne illness can be transmitted through the bite of an infected blacklegged (deer) tick and causes flu-like symptoms similar to those seen in Lyme disease.
The article “Tick-Borne Myopericarditis with Positive Anaplasma, Lyme, and Epstein Barr Virus (EBV) Serology: A Case Report,” by Arshad and colleagues features a 61-year-old man from New Jersey who presented to the emergency department with fever, chills, myalgia, nausea, vomiting, and diarrhea.¹ He also had lightheadedness and shortness of breath. His symptoms had been ongoing for two weeks.
The man’s medical history included hypertension, hyperlipidemia, and coronary artery disease.
“Further history-taking revealed a recent history of a tick found in his clothes.” He was subsequently treated successfully with doxycycline.
How Common Are Cardiac Complications From Anaplasmosis?
Cardiac complications remain uncommon compared with fever, headache, fatigue, and muscle aches. However, delayed diagnosis or overlapping infections may increase the risk of severe presentations.
Can Anaplasmosis Cause Myocarditis or Carditis?
“This case highlights an uncommon presentation of carditis in acute Lyme and anaplasma infections with the associated false-positive serology of EBV.”
Positive test results later confirmed acute Lyme disease and anaplasma infections, along with a positive serology of Epstein Barr virus.
According to the authors, “Electrocardiography (EKG) was notable for tachycardia with global mild ST elevations throughout the EKG.” A mild troponin leakage was present, which progressed to septic shock and required vasopressor therapy.
“In this case, the most likely diagnosis is myopericarditis related to anaplasmosis. However, the presence of overlapping Lyme disease cannot be ascertained.”
Cases involving multiple infections may complicate interpretation of symptoms and testing, highlighting some of the limitations of tick-borne disease testing.
Authors’ Takeaways
- “In endemic regions as in the Northeastern United States, tick-borne carditis should always be included in the differential diagnosis.”
- “Lack of other clinical manifestations of Lyme disease including rash history should not prompt exclusion of Lyme disease from the differential diagnosis.”
- “Clinical presentation can be potentially fatal with cardiogenic shock. However, prompt initiation of antibiotic therapy, i.e. doxycycline usually results in rapid clinical improvement.”
- “The EBV serology can be falsely positive among those with acute Lyme disease.”
Frequently Asked Questions
Can untreated anaplasmosis cause complications?
Untreated anaplasmosis may lead to severe complications including respiratory failure, neurologic involvement, organ dysfunction, and rarely cardiac complications.
Can anaplasmosis affect the heart?
Although uncommon, anaplasmosis has been associated with myocarditis, carditis, and other inflammatory heart complications.
Can Lyme disease and anaplasmosis occur together?
Yes. Coinfections can occur because the same tick may transmit multiple pathogens, potentially complicating diagnosis and treatment.
Clinical Takeaway
Anaplasmosis is usually recognized as a febrile tick-borne illness, but uncommon cardiac complications may occur. Clinicians should consider coinfections and atypical presentations when patients develop chest symptoms, arrhythmias, or signs of myocarditis following tick exposure.
Related Articles
Anaplasmosis symptoms and diagnosis
Can anaplasmosis cause heart problems?
Podcast: A woman with anaplasmosis and babesia infection
References
- Arshad H, Oudah B, Mousa A, Kakhktsyan T, Abu-Abaa M, Agarwal A. Tick-Borne Myopericarditis With Positive Anaplasma, Lyme, and Epstein Barr Virus (EBV) Serology: A Case Report. Cureus. 2023 Jun 14;15(6):e40440. doi: 10.7759/cureus.40440. PMID: 37456368; PMCID: PMC10349210.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
