Persistent parasitemia after acute babesiosis
Persistent parasitemia after acute babesiosis
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DOI：
10.1056/nejm199807163390304
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发表时间：
1998-07-16
影响因子：
158.5
通讯作者：
Persing, DH
中科院分区：
文献类型：
--
作者：
Krause, PJ;Spielman, A;Persing, DH
背景巴贝斯虫病是由原生动物田鼠巴贝斯虫引起的一种人畜共患病，由于寄生虫血症是暂时性的，当症状轻微时通常也不治疗。然而，用于诊断这种感染的显微镜方法是不敏感的，很少有感染者被纵向跟踪。我们比较了寄生虫血症的持续时间的人谁接受了特定的antibabesial治疗，在沉默感染的人谁没有收到特定的therapeutic.Methods四十六巴贝虫感染的主题确定从1991年至1996年在一个前瞻性的，以社区为基础的研究，旨在检测发病和血清转换之间的居民康涅狄格州东南部和布洛克岛，罗得岛。通过薄血涂片（Bab）每3个月监测一次急性巴贝斯虫病受试者，持续27个月。结果在24例无特异性症状、未接受特异性治疗的受试者中，巴贝斯虫DNA在血液中平均持续存在82天。在22名接受克林霉素和奎宁治疗的急性病受试者中，巴贝斯虫DNA持续了16天（P = 0.03），其中9人因治疗而出现副作用。在未接受特异性治疗的受试者中，有5名巴贝斯虫DNA存在3个月或3个月以上的受试者的巴贝斯虫病症状平均持续114天，而7名DNA检测不到3个月的受试者的巴贝斯虫病症状仅持续15天（P
Background Babesiosis, a zoonosis caused by the protozoan Babesia microti, is usually nor treated when the symptoms are mild, because the parasitemia appears to be transient. However, the microscopical methods used to diagnose this infection are insensitive, and few infected people have been followed longitudinally. We compared the duration of parasitemia in people who had received specific antibabesial therapy with that in silently infected people who had not received specific therapy.Methods Forty-six babesia-infected subjects were identified from 1991 through 1996 in a prospective, community-based study designed to detect episodes of illness and of seroconversion among the residents of southeastern Connecticut and Block Island, Rhode island. Subjects with acute babesial illness were monitored every 3 months for up to 27 months by means of thin blood smears, Bab. microti polymerase-chain-reaction assays, serologic tests, and questionnaires.Results Babesial DNA persisted in the blood for a mean of 82 days in 24 infected subjects without specific symptoms who received no specific therapy. Babesial DNA persisted for 16 days in 22 acutely ill subjects who received clindamycin and quinine therapy (P = 0.03), of whom 9 had side effects from the treatment. Among the subjects who did not receive specific therapy, symptoms of babesiosis persisted for a mean of 114 days in five subjects with babesial DNA present for 3 or more months and for only 15 days in seven others in whom the DNA was detectable for less than 3 months (P