Initial infectious work up included Anaplasmosis/Ehrlichia serology for IgG antibody (Negative - <1:16), Ehrlichiosis/Anaplasmosis PCR (negative), West Nile IgM (negative), Babesia microtti IgM (< 1:16), Babesia microtti PCR (negative), and Lyme serology (non reactive). This evidence concerns the gene CD40LG and human granulocytic anaplasmosis.