Cunha B A, Nausheen S, Szalda D
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, NY 11501, USA.
Eur J Clin Microbiol Infect Dis. 2007 Jul;26(7):505-8. doi: 10.1007/s10096-007-0325-1.
Reported here is a rare case of babesiosis with pulmonary complications followed by a review of the literature. Babesiosis presents clinically as a malaria-like illness with fever, chills, headache, fatigue with lymphopenia, atypical lymphocytes, mildly or transiently elevated serum transaminases, thrombocytopenia, and increased lactate dehydrogenase (LDH) levels. The diagnosis of babesiosis is based on identification of Babesia spp. on a peripheral blood smear. Babesiosis is usually mild in normal hosts, but it may be severe or even fatal in asplenic patients. Pulmonary manifestations are rare in babesiosis, but non-cardiogenic pulmonary edema (NCPE) is the most frequent manifestation. NCPE in babesiosis does not appear to be related to the degree of parasitemia or splenic function and its onset may be early or late. NCPE usually resolves rapidly with supportive treatment; it is rarely fatal. Clinicians should suspect NCPE in patients with babesiosis who acutely develop shortness of breath and have chest radiograph findings compatible with acute pulmonary edema without cardiomegaly or pleural effusions.
本文报告了一例罕见的伴有肺部并发症的巴贝斯虫病病例，并对相关文献进行了综述。巴贝斯虫病临床上表现为类似疟疾的疾病，伴有发热、寒战、头痛、疲劳、淋巴细胞减少、非典型淋巴细胞、血清转氨酶轻度或短暂升高、血小板减少以及乳酸脱氢酶（LDH）水平升高。巴贝斯虫病的诊断基于在外周血涂片上鉴定出巴贝斯虫属。巴贝斯虫病在正常宿主中通常较轻，但在无脾患者中可能严重甚至致命。肺部表现在巴贝斯虫病中较为罕见，但非心源性肺水肿（NCPE）是最常见的表现。巴贝斯虫病中的NCPE似乎与寄生虫血症程度或脾功能无关，其发病可能早或晚。NCPE通常通过支持治疗迅速缓解；很少致命。临床医生应怀疑患有巴贝斯虫病且急性出现呼吸急促、胸部X线检查结果与急性肺水肿相符但无心脏扩大或胸腔积液的患者患有NCPE。
