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CC BY-NC-ND 4.0 · Tierarztl Prax Ausg G Grosstiere Nutztiere 2024; 52(06): 352-360
DOI: 10.1055/a-2418-6540
Kasuistik

Die granulozytäre Anaplasmose des Pferdes: ein Fallbericht und die epidemiologische Situation mit Fokus auf Deutschland

Equine granulocytic anaplasmosis (EGA): Case description and overview of the epidemiological situation with focus on Germany
Carla Wiebke Axt
1   Laboklin GmbH and Co. KG, Bad Kissingen
,
Andrea Springer
2   Institut für Parasitologie, Zentrum für Infektionsmedizin, Stiftung Tierärztliche Hochschule Hannover, Hannover
,
Arno Besse
3   Tierarztpraxis Dr. Arno Besse, Lebach
,
Torsten J. Naucke
1   Laboklin GmbH and Co. KG, Bad Kissingen
,
Elisabeth Müller
1   Laboklin GmbH and Co. KG, Bad Kissingen
,
Christina Strube
2   Institut für Parasitologie, Zentrum für Infektionsmedizin, Stiftung Tierärztliche Hochschule Hannover, Hannover
,
Ingo Schäfer
1   Laboklin GmbH and Co. KG, Bad Kissingen
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Zusammenfassung

Die equine granulozytäre Anaplasmose (EGA) ist eine zeckenübertragene Infektionserkrankung und wird durch den Erreger Anaplasma (A.) phagocytophilum ausgelöst. Als Vektoren gelten Zecken des sogenannten Ixodes (I.) ricinus/I. persulcatus-Komplexes in Zentral-, Nord-, West- und Osteuropa, in Deutschland überwiegend der Gemeine Holzbock, I. ricinus. Die Frühjahrs- und Sommermonate, insbesondere April bis Juli, stellen die Hochphase der Aktivität von I. ricinus in Zentraleuropa dar. Aufgrund der Veränderung klimatischer Bedingungen besteht mittlerweile ganzjährig das Risiko einer Zeckenexposition und damit auch einer Infektion mit A. phagocytophilum. Der beschriebene klinische Fall unterstreicht die saisonale Hochphase des Infektionsrisikos mit Vorstellung des Pferdes im Juni. Die klinische Symptomatik ist mit Fieber häufig unspezifisch und eine Thrombozytopenie ist der bedeutendste hämatologische Befund. Zur Diagnosestellung einer Infektion bzw. eines Erregerkontaktes sind direkte und indirekte Nachweisverfahren verfügbar. Eine positive PCR bestätigt wie im dargestellten Fall eine akute Infektion, positive Antikörperspiegel sprechen für einen Erregerkontakt in der (jüngeren) Vergangenheit. Einschlusskörperchen, sogenannte Morulae, können schnell und kostengünstig in Ausstrichen aus dem peripheren Blut nachgewiesen werden und finden sich bevorzugt in neutrophilen Granulozyten, seltener in eosinophilen Granulozyten. Die Mikroskopie weist jedoch eine geringere Sensitivität im Vergleich zur PCR-Diagnostik auf. Bei dem beschriebenen Pferd gelang der Nachweis von Morulae im EDTA-Blut trotz positiver PCR nicht. Intrazellulär wirksame Antibiotika wie z. B. Oxytetracyclin und/oder Doxycyclin gelten als Therapie der Wahl und führen wie im beschriebenen Fall meist zu einer schnellen klinischen Besserung an EGA erkrankter Pferde. Eine Therapiekontrolle mittels PCR wird 5–8 Tage nach Abschluss der Behandlung empfohlen, um eine Elimination des Erregers zu bestätigen. Ob bzw. wie lange Antikörper gegen A. phagocytophilum möglicherweise protektiv gegenüber einer erneuten Infektion sein könnten, ist bisher unbekannt. In der Humanmedizin wird A. phagocytophilum in der nördlichen Hemisphäre als „emerging human pathogen“ mit steigender klinischer Bedeutung eingestuft.

Abstract

Equine granulocytic anaplasmosis (EGA) is a tick-borne disease caused by Anaplasma (A.) phagocytophilum. In Central, Northern, Western, and Eastern Europe, ticks of the Ixodes (I.) ricinus/I. persulcatus complex, in Germany mainly I. ricinus, are considered as vectors. Ixodes ricinus ticks show peaks of activity during the spring and summer months, particularly April to July. Changing climatic conditions, however, have meanwhile led to a year-round risk of tick exposure and thus infections with A. phagocytophilum. The presented case report underlines the seasonal peak phase of the infection risk in that the presentation of the horse to the veterinarian occurred in June. Additionally, clinical signs – including fever – are mostly unspecific and thrombocytopenia represents the most significant hematological abnormality. Direct and indirect detection methods are available for the diagnosis of an infection or contact with the pathogen. A positive PCR confirms an acute infection, as in the presented case, while positive antibody levels indicate contact with the pathogen in the (recent) past. Additionally, inclusion bodies, so called morulae, may be detected rapidly and inexpensively in smears derived from the peripheral blood and are predominantly found in neutrophilic granulocytes, less frequently in eosinophilic granulocytes. However, microscopy has a lower sensitivity compared to PCR-testing. In the presented case, morulae could not be detected in EDTA blood despite positive PCR. Antibiotics with intracellular activity, such as oxytetracycline and/or doxycycline are the treatment of choice and, as in the described case, often result in rapid clinical improvement in horses suffering from EGA. The elimination of the pathogen should be confirmed by PCR-testing 5–8 days after the completion of the antibiotic therapy. Whether and how long antibodies against A. phagocytophilum could possibly be protective against reinfection remains unknown. In humans, A. phagocytophilum is classified as an emerging pathogen of increasing clinical importance in the northern hemisphere.

Schlüsselwörter

Anaplasma phagocytophilum - Klinik - Behandlung - Prävalenz

Keywords

Anaplasma phagocytophilum - clinical signs - therapy - prevalence


Publication History

Received: 04 September 2024

Accepted: 11 September 2024

Article published online:
04 December 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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