Babesia infection in Italy.
Babesia infection in Italy.
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DOI：
10.1016/s1473-3099(04)00970-3
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发表时间：
2004-04-01
期刊：
影响因子：
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通讯作者：
Gherlinzoni, Filippo
中科院分区：
文献类型：
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作者：
Piccaluga, Pier Paolo;Poletti, Giovanni;Gherlinzoni, Filippo
我们的患者是一名 55 岁男性，1980 年因霍奇金病接受了脾切除术。1998 年开始接受弥漫性大 B 细胞淋巴瘤化疗。化疗期间，患者出现发热（39℃）、神志不清、严重贫血、血小板减少、血红蛋白尿、乳酸脱氢酶、肌酐和胆红素升高。他没有蜱虫叮咬、出国旅行或输血史。巴贝虫病是通过观察外周血涂片中红细胞内的寄生包涵体来诊断的（图中概述了提示巴贝虫感染的红细胞内原生动物的存在）。分歧巴贝斯虫抗体滴度呈弱阳性。使用克林霉素（600 mg，每日三次，静脉注射）和硫酸奎宁（650 mg，每日三次，口服）进行特异性治疗，持续 15 天。治疗3天后发烧消退； 6天后，寄生虫从血涂片中消失。感染从未复发。巴贝虫病是由巴贝虫属红细胞内原生动物引起的蜱传人畜共患病。自 1956 年描述第一例以来，美国已报告数百例人类巴贝斯虫病，欧洲约 30 例，其他地方只有少数病例。田鼠巴贝虫是美国报告病例中最常见的物种，而分歧巴贝虫则最常见于欧洲病例。其他物种已在美国被鉴定并通过分子表征进行描述，包括 WA1、CA1 和 MO1 类型。我们相信我们的患者是意大利首例巴贝虫病病例。分子表征（在美国亚特兰大疾病控制和预防中心进行）表明，该寄生虫虽然与分歧巴贝斯虫有关，但却是一种以前未被识别的巴贝虫生物，被定义为 EU1（欧盟 1）。
Our patient is a 55-year-old man who had undergone to splenectomy for Hodgkin’s disease in 1980. He started chemotherapy for a diffuse large B-cell lymphoma in 1998. During chemotherapy, the patient presented with fever (39 C), confusion, severe anaemia, thrombocytopenia, haemoglobinuria, and lactate dehydrogenase, creatinine, and bilirubine elevation. He had no history of tick bites, foreign travel, or transfusion. Babesiosis was diagnosed by observing parasitic inclusions in erythrocytes on peripheralblood smears (figure, presence of intraerythrocytic protozoa suggestive for babesia infection is outlined). Antibody titre against Babesia divergens was weakly positive. Specific therapy with clindamicine (600 mg thrice daily intravenously) and quinine sulphate (650 mg thrice daily orally) was administered for 15 days. Fever resolved after 3 days of therapy; parasites disappeared from blood-smears after 6 days. The infection never recurred. Babesiosis is a tick-borne zoonosis caused by intraerythrocytic protozoa of the genus Babesia. Since the first case was described in 1956, hundreds of cases of human babesiosis have been reported in the USA, about 30 in Europe, and only a few cases elsewhere. Babesia microti is the species most often responsible for the cases reported in USA, whereas B divergens is most frequently found in European cases. Other species have been identified in USA and described by molecular characterisation, including WA1, CA1, and MO1 types. We believe our patient was the first case of babesiosis in Italy. The molecular characterisation (performed at the Centers for Disease Control and Prevention, Atlanta, USA) showed that the parasite, although related to B divergens, was a previously unrecognised babesia organism, defined as EU1 (European Union 1).