Severe babesiosis in Long Island: Review of 34 cases and their complications
Severe babesiosis in Long Island: Review of 34 cases and their complications
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DOI：
10.1086/319742
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发表时间：
2001-04-15
影响因子：
11.8
通讯作者：
Jimenez-Lucho, VE
中科院分区：
文献类型：
--
作者：
Hatcher, JC;Greenberg, PD;Jimenez-Lucho, VE
在13年的病程中，连续34名患者因被诊断为严重巴贝斯虫感染而住院。从出现症状到确诊的平均时间为15天。与未感染的发热对照患者相比，感染患者主诉不适、关节痛和肌肉痛、呼吸急促的频率明显增加(P<；0.05)，他们更容易出现血小板减少和肝功能异常(P<；0.05)。41%的巴贝斯症患者出现并发症，如急性呼吸衰竭、弥漫性血管内凝血、充血性心力衰竭和肾功能衰竭。数据分析显示，复杂的巴贝斯虫病更常见的是存在严重贫血(血红蛋白水平为10%；P=0.08)，患者接受包括克林霉素、奎宁、阿托瓦酮或阿奇霉素在内的联合药物治疗，尽管接受治疗，寄生虫血症仍持续平均8.5天(范围为3-21天)。对7例患者进行换血，有效降低了高寄生虫血症水平。三名患者死亡。及时识别和治疗巴贝斯虫病可能会改善预后。
Thirty-four consecutive patients were hospitalized with diagnosis of severe Babesia infection over the course of 13 years. The average time from onset of symptoms to diagnosis was 15 days. When compared with uninfected febrile control patients, affected patients complained significantly more often of malaise, arthralgias and myalgias, and shortness of breath (P < .05), and they more often had thrombocytopenia and abnormal liver function (P < .05). Forty-one percent of patients with Babesia developed complications such as acute respiratory failure, disseminated intravascular coagulation, congestive heart failure, and renal failure. Analysis of data revealed that complicated babesiosis was more commonly associated with the presence of severe anemia (hemoglobin level 10%; P = .08), Patients were treated with a combination of drugs that included clindamycin, quinine, atovaquone, or azithromycin, Despite treatment, parasitemia persisted for an average of 8.5 days (range, 3-21 days). Exchange transfusion was performed for 7 patients, and it effectively reduced the high levels of parasitemia. Three patients died. Improved outcomes may result with prompt recognition and treatment of babesiosis.