Table 3.

Overview of clinical findings in HGA patients

Country	Age	Tb	I	Clinical signs	Laboratory findings	D	H	T	References
Austria	33	+	8	Fever, arthralgia, headache	Thrombocytopenia; increased levels of CRP, lactate dehydrogenase and bilirubin	S	+	+	[146]
	33	+	7	Fever, headache, sweats, splenomegaly	Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, neopterin; elevated erythrocyte sedimentation rate	S	+	+	[94]
	40	+	n	Fever, arthralgia, headache, sweats	Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, procalcitonin, neopterin; elevated erythrocyte sedimentation rate	S	+	+
	63	+	8	Fever, arthralgia, headache, vertigo, sweats, splenomegaly	Thrombocytopenia; increased levels of CRP, lactate dehydrogenase, neopterin; elevated erythrocyte sedimentation rate	S	+	+
	46	+	6	Fever, arthralgia, headache, sweats, splenomegaly	Thrombocytopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, neopterin; elevated erythrocyte sedimentation rate	S	−	−
	32	−	n	Fever, arthralgia, headache, sweats	Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, procalcitonin, neopterin; elevated erythrocyte sedimentation rate	S	+	+
	38	+	9	Fever, myalgia, arthralgia, headache	Increased levels of CRP and creatine kinase	P	+	+	[95]
France	47	−	n	Fever, myalgia, arthralgia, headache, sweats, cough (atypical pneumonitis)	Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase and fibrinogen	P	+	+	[101]
Italy	33	+	n	–	nd	S	n	+	[118]
	69	+	n	–	nd	S	n	+
	41	+	n	Fever, myalgia, arthralgia	nd	S	n	+
	48	+	n	EM	nd	S	n	+
	17	+	n	Fever, myalgia, arthralgia, headache, nucal rigidity, aseptic meningitis	nd	S	n	+
Netherlands	58	−	n	Fever, chills, diarrhea	Thrombocytopenia; leucopenia; increased levels of AST/ALT	P	+	+	[106]
Poland	40	−	n	Fever, headache, hepatomegaly	Thrombocytopenia; increased levels of CRP, AST/ALT	P	+	+	[109]
	41	+	7	Fever, headache, meningeal signs, vertigo, weakness, hepatomegaly	Thrombocytopenia; increased levels of AST/ALT	S	+	+
	22	+	7	Fever, headache, vomiting, abdominal pain, diarrhea, splenomegaly	Thrombocytopenia; leucopenia; increased levels of AST/ALT	P	+	+
Scotland	40	+	3	−	Lactate dehydrogenase (248 U/L)	S	n	+	[74]
Slovenia	11	−	9	Fever, headache, conjunctivitis, erythematous throat, abdominal pain (right upper quadrant abdominal tenderness)	Thrombocytopenia; leucopenia; increased levels of CRP	P	+	+	[147]
	36	−	10	Tachypnea, tachycardia, hypotension, ARDS	Thrombocytopenia; increased levels of CRP, AST/ALT	P	+	+	[75]
	70	+	12	Fever, myalgia, arthralgia, headache, vomiting, conjunctivitis, lymphadenopathy	Thrombocytopenia; increased levels of CRP	P	–	–	[91]
	59	+	21	Fever, myalgia, arthralgia, headache, chills, vertigo	Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT	S	+	+	[148]
	43	+	7	Fever, myalgia, arthralgia, headache, chills, vertigo, dry cough (pneumonia)	Increased levels of CRP, AST/ALT	S	+	+
	55	+	30	Fever, myalgia, arthralgia, headache, vertigo, vomiting	Thrombocytopenia; leucopenia; increased levels of CRP	P	−	−
	36	+	15	Fever, arthralgia, headache, chills, vomiting, lymphadenopathy, hepatosplenomegaly	Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT	S	+	−	[149]
	22	+	n	Fever, myalgia, arthralgia, headache, conjunctivitis, EM	Thrombocytopenia; leucopenia; increased levels of CRP, AST/ALT	S	+	+	[150]
	63	+		Fever, myalgia, arthralgia, headache	Thrombocytopenia; leucopenia; increased levels of CRP, procalcitonin	P	+	+	[151]
	14	+	n	Fever, chills, neck and lumbar pain and passing of dark urine, jaundice and a discrete maculopapular rash on the trunk and neck, systolic murmur	Thrombocytopenia, leucopenia; increased levels of CRP, AST/ALT, lactate dehydrogenase, bilirubin	P	+	+	[152]
Spain	19	+	15	Fever, myalgia, headache, abdominal pain	Thrombocytopenia, leucopenia; increased levels of AST/ALT	P	+	+	[113]
Sweden	41	−	n	Fever, myalgia, headache, bilateral conjunctivitis, tachypnea, diffuse rash on the face and trunk, dry cough and dyspnea (bilateral interstitial infiltrates)	Increased levels of CRP, AST/ALT; intrahepatic cholestasis with increased serum bilirubin, serum alkaline phosphatase and serum glutamyl transpeptidase	P	+	+	[133]
	5	n	n	Fever, headache, facial palsy	nd	P	+	n	[132]
	41	n	n	Fever, headache, dyspnea, cough, conjunctivitis, rash	Increased levels of AST/ALT	P	+	+
	32	+	30	Fever, headache, chills, stiff neck	Thrombocytopenia	P	+	+

Abbreviations: Tb, history of tick bite; I, incubation (days); nd, not determined; D, diagnostic: S, serology; P, PCR; H, hospitalization; T, treatment received; n, not specified; −, no; +, yes

Note: the table is based on 33 cases