A fatal case of babesiosis in Missouri: Identification of another piroplasm that infects humans
A fatal case of babesiosis in Missouri: Identification of another piroplasm that infects humans
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DOI：
10.7326/0003-4819-124-7-199604010-00004
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发表时间：
1996-04-01
影响因子：
39.2
通讯作者：
Gorenflot, AF
中科院分区：
文献类型：
--
作者：
Herwaldt, BL;Persing, DH;Gorenflot, AF
目的：描述第一例报道病例的病原体（MO 1）设计：病例报告、血清学检测、动物接种和分子研究。地点：密苏里州东南部。患者：一名73岁男性，曾接受脾切除术，并有一例致命的巴贝虫病。测量结果：通过间接免疫荧光抗体试验和免疫沉淀法测定患者血清标本与各种巴氏杆菌抗原的反应性物种将治疗前从患者获得的全血接种到仓鼠和沙鼠以及小牛和大角羊中，这些小牛和大角羊已经进行了脾切除术并使用地塞米松进行了免疫抑制。通过聚合酶链反应进行宽范围扩增，从患者血液中回收梨形虫特异性核小亚基核糖体DNA;对扩增产物的144个碱基对区域进行测序;并进行系统发育分析，以比较MO 1与各种Babelians物种。间接免疫荧光抗体检测显示，患者血清与在欧洲引起牛和人类巴贝虫病的巴贝斯虫有强烈反应性，但它与B的反应性很小。microti和WA 1，这是以前已知的在美国引起人畜共患巴贝虫病的piroximus。免疫沉淀显示MO 1与B的关系更为密切。比B发散。犬（犬寄生虫）。实验接种动物均未出现明显的寄生虫血症。DNA测序后的系统发育分析表明，MO 1与B的关系最密切。结论：虽然MO 1可能与B不同。分歧，这两个共享的形态，抗原和遗传特征; MO 1可能代表一个Babelium物种以前没有认识到感染人类。医务人员应该意识到，在美国，即使患者对B呈血清阴性，也可能患有危及生命的巴贝斯虫病。microti和WA 1抗原。
Objective: To characterize the etiologic agent (MO1) of the first reported casDesign: Case report, serologic testing, animal inoculations, and molecular studies.Setting: Southeastern Missouri.Patient: A 73-year-old man who had had a splenectomy and had a fatal case of babesiosis.Measurements: Serum specimens from the patient were assayed by indirect immunofluorescent antibody testing and immunoprecipitation for reactivity with antigens from various Babesia species. Whole blood obtained from the patient before treatment was inoculated into hamsters and jirds and into calves and bighorn sheep that had had splenectomy and were immunosuppressed with dexamethasone. Piroplasm-specific nuclear small-subunit ribosomal DNA was recovered from the patient's blood by using broad-range amplification with the polymerase chain reaction; a 144 base-pair region of the amplification product was sequenced; and phylogenetic analysis was done to compare MO1 with various Babesia species.Results: Indirect immunofluorescent antibody testing showed that the patient's serum had strong reactivity with Babesia divergens, which causes babesiosis in cattle and humans in Europe, but that it had minimal reactivity with B. microti and WA1, which are the piroplasms previously known to cause zoonotic babesiosis in the United States. Immunoprecipitations showed that MO1 is more closely related to B. divergens than to B. canis (a canine parasite). None of the experimentally inoculated animals became demonstrably parasitemic. Phylogenetic analyses, after DNA sequencing, showed that MO1 is most closely related to B. divergens (100% similarity).Conclusions: Although MO1 is probably distinct from B. divergens, the two share morphologic, antigenic, and genetic characteristics; MO1 probably represents a Babesia species not previously recognized to have infected humans. Medical personnel should be aware that patients in the United States can have life-threatening babesiosis even though they are seronegative to B. microti and WA1 antigen.