Uhnoo I, Cars O, Christensson D, Nyström-Rosander C
Department of Infectious Diseases, University Hospital, Uppsala, Sweden.
Scand J Infect Dis. 1992;24(4):541-7. doi: 10.3109/00365549209052642.
A 34-year-old splenectomized man presented with fever, myalgia and dysuria. His condition rapidly deteriorated, he became anuric and developed severe haemolytic anaemia, thrombocytopenia and fibrinolysis. Peripheral blood smears revealed intra-erythrocytic parasites consistent with Babesia divergens in 40% of the erythrocytes. The diagnosis was confirmed by gerbil inoculation and by a significant rise in antibody titer. Blood exchange transfusion reduced the number of babesia infected erythrocytes to 1%. Parenteral therapy with a combination of quinine and clindamycin eradicated parasitaemia after 10 days of treatment and the patient rapidly improved. Renal failure necessitated haemodialysis for one month, whereafter the patient made a full recovery. Human babesiosis is a rare disease, but with a potential fatal outcome and should be considered as a diagnostic alternative in splenectomized and otherwise immunocompromised individuals with severe febrile illnesses.
一名34岁的脾切除男性患者出现发热、肌痛和排尿困难。他的病情迅速恶化，出现无尿，并发展为严重的溶血性贫血、血小板减少和纤维蛋白溶解。外周血涂片显示40%的红细胞内有与分歧巴贝斯虫相符的红细胞内寄生虫。通过沙鼠接种和抗体滴度显著升高确诊。换血疗法将感染巴贝斯虫的红细胞数量减少至1%。联合使用奎宁和克林霉素进行肠外治疗，治疗10天后消除了寄生虫血症，患者病情迅速好转。肾衰竭需要进行一个月的血液透析，之后患者完全康复。人类巴贝斯虫病是一种罕见疾病，但可能导致致命后果，对于脾切除及其他免疫功能低下且患有严重发热性疾病的个体，应将其视为一种诊断选择。
