First confirmed autochthonous case of human Babesia microti infection in Europe
First confirmed autochthonous case of human Babesia microti infection in Europe
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DOI：
10.1007/s10096-007-0333-1
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发表时间：
2007-08-01
影响因子：
4.5
通讯作者：
Straube, E.
中科院分区：
文献类型：
--
作者：
Hildebrandt, A.;Hunfeld, K.-P.;Straube, E.
摘要一位42岁女性急性骨髓性白血病患者，在接受第一个周期的特定化疗后，出现发烧及严重胸痛。排除了急性心肌梗死，但令人惊讶的是，红细胞中的寄生虫包涵体在Pappenheim和Giemsa染色的外周血涂片中变得明显。患者不记得蜱虫叮咬，但承认在其近期病史中接受过多次输血。通过试纸测试排除了疟疾的可能性。通过特异性聚合酶链反应（PCR），最终建立了田鼠巴伯螨感染的诊断方法。特异性治疗开始后6周，PCR转为阴性，IgG滴度为1：128的阳性免疫荧光试验（IFA）表明血清转化。随后对参与向患者输注血液制品的供体进行筛选，结果显示44例个体中有1例对微小巴氏杆菌具有临界反应性（IgG滴度1：32）。患者和检测呈阳性的献血者都没有去过北美或亚洲。因此，这是欧洲首次确认的本土人类感染。
A 42-year-old female patient with acute myeloid leukemia presented with fever and heavy chest pain after her first cycle of specific chemotherapy. Acute myocardial infarction was excluded, but surprisingly, parasitic inclusions in erythrocytes became obvious in Pappenheim and Giemsa-stained peripheral blood smears. The patient did not remember a tick bite but acknowledged having received several blood transfusions in her recent medical history. Suspicion of malaria was ruled out by use of a dip-stick test. The diagnosis of Babesia microti infection was finally established by specific polymerase chain reaction (PCR). Six weeks after initiation of specific treatment, PCR turned negative and a positive immunoflourescence assay (IFA) with an IgG titer of 1:128 indicated seroconversion. Subsequent screening of donors involved in the transfusion of blood products to the patient demonstrated borderline reactivity for Babesia microti (IgG-titer 1:32) in 1 out of 44 individuals. Neither the patient nor the positively tested blood donor had travelled to North America or Asia. Therefore, this is the first confirmed autochthonous human infection in Europe.