Clinically differential diagnosis of human granulocytic anaplasmosis and severe fever with thrombocytopenia syndrome

Author:

Kim Dong-Min,Yu Byung Jun,Kim Da Young,Seo Jun-Won,Yun Na-Ra,Kim Choon Mee,Kim Young Keun,Jung Sook In,Kim Uh Jin,Kim Seong Eun,Kim Hyun ah,Kim Eu Suk,Hur Jian,Lee Sun Hee,Jeong Hye Won,Heo Jung Yeon,Jung Dong Sik,Kim Jieun,Park Sun Hee,Kwak Yee Gyung,Lee Sujin,Lim Seungjin,Chatterjee Shilpa

Abstract

AbstractThis study analyzed HGA and SFTS in patients with suspected tick-borne infection by focusing on key differences that clinicians can easily recognize. A retrospective analysis was performed on confirmed patients with HGA or SFTS in 21 Korean hospitals from 2013 to 2020. A scoring system was developed by multivariate regression analysis and accuracy assessment of clinically easily discriminable parameters was performed. The multivariate logistic regression analysis revealed that sex (especially male sex) (odds ratio [OR] 11.45, P = 0.012), neutropenia (< 1500) (OR 41.64, P < 0.001), prolonged activated partial thromboplastin time (OR 80.133, P < 0.001), and normal C-reactive protein concentration (≤ 1.0 mg/dL; OR 166.855, P = 0.001) were significantly associated with SFTS but not with HGA. Each factor, such as meaningful variables, was given 1 point, and a receiver-operating characteristic curve with a cutoff value (> 1) in a 5-point scoring system (0–4 points) was analyzed to evaluate the accuracy of differentiation between HGA and SFTS. The system showed 94.5% sensitivity, 92.6% specificity, and an area under the receiver-operating characteristic curve of 0.971 (0.949–0.9). Where HGA and SFTS are endemic, the scoring system based on these four parameters such as sex, neutrophil count, activated partial thromboplastin time, and C-reactive protein concentration will facilitate the differential diagnosis of HGA and SFTS in the emergency room in patients with suspected tick-borne infectious diseases. 

Funder

Chosun University

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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