What does it mean to have a past infection with Anaplasma phagocytophilum (causing Human Granulocytic Ehrlichiosis (HGE)) and what treatment is necessary?

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Last updated: December 27, 2025View editorial policy

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Understanding Your Anaplasma Test Results

Your lab results show you had a past infection with Anaplasma phagocytophilum (the bacteria that causes Human Granulocytic Anaplasmosis), but you do not have an active infection now and do not need treatment. 1

What These Numbers Mean

Your test measured two types of antibodies (proteins your immune system makes to fight infections):

  • IgG antibody level of 1:64: This is a low level of the "memory" antibody that stays in your blood after an infection has cleared. The level is below the threshold (1:128) that would suggest active disease. 1

  • IgM antibody level of <1:20: This is negative. IgM antibodies appear early during active infections, so the absence of IgM confirms you don't have a current infection. 2, 1

  • Interpretation: "Past Infection": Your body encountered this bacteria at some point in the past (possibly months or even years ago), fought it off, and retained some antibodies as a "memory" of that infection. 1

What This Bacteria Does

Anaplasma phagocytophilum is spread through tick bites and infects white blood cells called granulocytes. 2 When people get sick from it, they typically develop:

  • High fever (92-100% of cases)
  • Severe headache (82% of cases)
  • Muscle aches (77% of cases)
  • Chills and feeling generally unwell (97% of cases)
  • Symptoms usually appear 5-14 days after a tick bite 2

Blood tests during active infection typically show low white blood cell counts, low platelet counts, and mildly elevated liver enzymes. 2

Do You Need Treatment?

No treatment is necessary for past infection. 2, 1 Here's why:

  • This bacteria does not cause chronic infection in humans - once your immune system clears it, it's gone. 2
  • Antibodies can persist for years after the infection has resolved (studies show antibodies can remain detectable for 2+ years). 1
  • Treatment is only needed if you have active symptoms of infection. 2, 1

When Treatment Would Be Needed

Treatment with the antibiotic doxycycline (100 mg twice daily for 7-14 days) would only be necessary if you developed: 2, 1

  • Fever, chills, severe headache, and muscle aches within 5-21 days of a tick bite
  • Blood test abnormalities like low white blood cells or platelets
  • Clinical suspicion of active anaplasmosis

If treated, patients typically feel better within 24-48 hours. 2, 1

Important Points to Remember

  • You are not contagious - this infection spreads only through tick bites, not person-to-person. 2
  • Past infection does not provide immunity - you could potentially get infected again from another tick bite. 1
  • The mortality rate is very low (<1%) in healthy people but can be higher (up to 18%) in those with weakened immune systems. 1
  • Most cases are mild or even asymptomatic - many people clear the infection without ever knowing they had it. 2, 3

What to Watch For

If you develop fever, severe headache, and muscle aches after spending time outdoors in tick-prone areas (especially between late spring and fall), seek medical attention promptly and mention your past Anaplasma exposure. 2 Early treatment prevents complications, though serious complications are uncommon. 2

References

Guideline

Anaplasmosis Diagnosis and Treatment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Clinical diagnosis and treatment of human granulocytotropic anaplasmosis.

Annals of the New York Academy of Sciences, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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