Table 1. Vectorborne disease testing in case study of Heartland virus infection in elderly patient initially suspected of having ehrlichiosis, North Carolina, USA*.
| Test, specimen source | Specimen collection date | Result | Reference values |
|---|---|---|---|
| Vectorborne and zoonotic organisms | |||
| Ehrlichia chaffeensis IgG, serum | 2022 Mar 29 | 1:512 titer | <1:64 titer |
| Heartland virus real-time RT-PCR, serum | 2022 Apr 5 | Positive | Negative |
| Bourbon virus real-time RT-PCR, serum | 2022 Apr 5 | Negative | Negative |
| Bourbon PRNT, serum | 2022 Apr 5 | <1:10 titer, negative | <1:10 titer |
| Heartland PRNT, serum | 2022 Apr 5 | <1:10 titer, negative | <1:10 titer |
| Rickettsia rickettsii IgG, serum | 2022 Apr 5 | 1:64 titer | <1:128 titer |
| E. chaffeensis IgG, serum | 2022 Apr 5 | 1:1,024 titer | <1:64 titer |
| R. rickettsii IgG, serum | 2022 May 11 | 1:64 titer | <1:128 titer |
| E. chaffeensis IgG, serum | 2022 May 11 | 1:512 titer | <1:64 titer |
| E. chaffeensis PCR, serum | 2022 Mar 29 | Negative | Negative |
| Eastern equine encephalitis virus IgM, serum |
2022 Apr 2 |
Negative |
Negative |
| Viruses | |||
| Hepatitis A virus IgG, serum | 2022 Mar 28 | Positive | Negative |
| Hepatitis A virus IgM, serum | 2022 Mar 28 | Negative | Negative |
| Hepatitis B surface antibody, serum | 2022 Mar 28 | Negative | Negative |
| Hepatitis B core antibody, serum | 2022 Mar 28 | Negative | Negative |
| Hepatitis C virus antibody, serum | 2022 Mar 28 | Negative | Negative |
| Cytomegalovirus IgG, serum | 2022 Mar 28 | Positive | Negative |
| Cytomegalovirus IgM, serum | 2022 Mar 28 | Negative | Negative |
| Cytomegalovirus PCR, blood | 2022 Apr 1 | Negative | Negative |
| Herpes simplex virus 1/2 PCR, serum | 2022 Apr 2 | Negative | Negative |
| Herpes simplex virus 1 IgG, serum | 2022 Apr 2 | Positive | Negative |
| Herpes simplex virus 2 IgG, serum | 2022 Apr 2 | Negative | Negative |
| Epstein-Barr virus PCR, serum | 2022 Mar 31 | Negative | Negative |
| HIV-1/2 antibody, serum | 2022 Mar 29 | Negative | Negative |
| HIV-1 p24 antigen, serum | 2022 Mar 29 | Negative | Negative |
| Sapovirus PCR, feces | 2022 Mar 29 | Negative | Negative |
| Adenovirus F40/41 PCR, feces | 2022 Mar 29 | Negative | Negative |
| Astrovirus PCR, feces | 2022 Mar 29 | Negative | Negative |
| Norovirus PCR, feces | 2022 Mar 29 | Negative | Negative |
| Rotavirus A PCR, feces | 2022 Mar 29 | Negative | Negative |
| Respiratory syncytial virus PCR, nasopharyngeal swab | 2022 Mar 27 | Negative | Negative |
| Influenza A/B PCR, nasopharyngeal swab | 2022 Mar 27 | Negative | Negative |
| SARS-CoV-2 PCR, nasopharyngeal swab | 2022 Mar 27 | Negative | Negative |
| Parvovirus IgM, serum |
2022 Mar 29 |
Negative |
Negative |
| Bacteria | |||
| Streptococcus pneumoniae antigen, urine | 2022 Apr 2 | Negative | Negative |
| Legionella pneumophila antigen, urine | 2022 Mar 31 | Negative | Negative |
| Coxiella burnetii PCR, serum | 2022 Apr 2 | Negative | Negative |
| Campylobacter PCR, feces | 2022 Mar 29 | Negative | Negative |
| Plesiomonas shigelloides PCR, feces | 2022 Mar 29 | Negative | Negative |
| Salmonella PCR, feces | 2022 Mar 29 | Negative | Negative |
| Vibrio cholerae PCR, feces | 2022 Mar 29 | Negative | Negative |
| Vibrio PCR, feces | 2022 Mar 29 | Negative | Negative |
| Yersinia enterocolitica PCR, feces | 2022 Mar 29 | Negative | Negative |
| Enteroaggregative Escherichia coli PCR, feces | 2022 Mar 29 | Negative | Negative |
| Enteropathogenic E. coli PCR, feces | 2022 Mar 29 | Negative | Negative |
| Enterotoxigenic E. coli PCR, feces | 2022 Mar 29 | Negative | Negative |
| Enteroinvasive E. coli PCR, feces | 2022 Mar 29 | Negative | Negative |
| Shiga-toxin producing E. coli PCR, feces | 2022 Mar 29 | Negative | Negative |
| Clostridioides difficile PCR, feces | 2022 Mar 29 | Negative | Negative |
| Francisella tularensis, serum | 2022 Apr 2 | Negative | Negative |
| Culture, blood |
2022 Apr 5 |
No growth |
No growth |
| Parasites | |||
| Cryptosporidium PCR, feces | 2022 Mar 29 | Negative | Negative |
| Cryptosporidium cayetanensis PCR, feces | 2022 Mar 29 | Negative | Negative |
| Entamoeba histolytica PCR, feces | 2022 Mar 29 | Negative | Negative |
| Giardia lamblia PCR, feces | 2022 Mar 29 | Negative | Negative |
| Parasite smear, feces | 2022 Mar 31 | Negative | Negative |
| Toxoplasma IgM/IgG, serum | 2022 Apr 2 | Negative | Negative |
*Bold text indicates positive acute test result. PRNT, plaque reduction neutralization test; RT-PCR, reverse transcription PCR.