First case of human babesiosis in Germany -: Clinical presentation and molecular characterisation of the pathogen
First case of human babesiosis in Germany -: Clinical presentation and molecular characterisation of the pathogen
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DOI：
10.1016/j.ijmm.2007.01.002
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发表时间：
2007-06-01
影响因子：
4.1
通讯作者：
Hunfeld, Klaus-Peter
中科院分区：
文献类型：
--
作者：
Haeselbarth, Katja;Tenter, Astrid M.;Hunfeld, Klaus-Peter
巴贝斯虫病是一种常见的动物感染，在欧洲作为一种新出现的蜱传人畜共患病而日益受到关注。在这里，我们报告的第一例人类巴贝斯虫病在德国在一个63岁的脾切除德国患者复发的结节淋巴细胞为主的霍奇金淋巴瘤。在使用嵌合抗cd20抗体制剂（利妥昔单抗）治疗后，患者因贫血和血红蛋白尿引起的深色尿而住院。根据外周血涂片的纯寄生红细胞包涵体进行巴贝斯虫病的推定诊断，并通过巴贝斯虫特异性18S rDNA PCR证实。序列分析显示，该扩增子与最近描述的巴贝斯虫发散型巴贝斯虫/臭虫巴贝斯虫复合体内的EU1生物集群具有bbbb99 %的同源性。尽管接受了奎宁和克林霉素治疗，但患者复发并发展为慢性寄生虫病，需要再次治疗和阿托伐酮长期维持治疗，最终血清转化并清除寄生虫。我们的研究结果表明，人类巴贝斯虫病发生在德国，可以采取一个慢性过程中免疫功能低下的个体。(C) 2007 Elsevier GmbH版权所有。
Babesiosis is a common infection of animals and is gaining increasing attention as an emerging tick-borne zoonosis of humans in Europe. Here we report on the first case of human babesiosis in Germany in a 63-year-old splenectomised German patient with a relapse of nodular lymphocyte-predominant Hodgkin's lymphoma. After treatment with a chimeric anti-CD20 antibody preparation (Rituximab), the patient was hospitalised because of anaemia and dark urine from haemoglobinuria. Presumptive diagnosis of babesiosis was made based on puriform parasitic erythrocytic inclusions in peripheral blood smears and confirmed by Babesia-specific 18S rDNA PCR. Sequence analysis revealed a > 99% homology of the amplicon with the recently described EU1 organism clustering within the Babesia divergens/ Babesia odocoilei complex. Despite treatment with quinine and clindamycin the patient relapsed and developed chronic parasitaemia requiring re-treatment and long-term maintenance therapy with atovaquone before he eventually seroconverted and the parasite was cleared. Our findings suggest that human babesiosis occurs in Germany and can take a, chronic course in immunocompromised individuals. (C) 2007 Elsevier GmbH. All rights reserved.