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犬巴贝斯虫病的临床管理

Clinical management of canine babesiosis.

作者信息

Ayoob Ashley L, Hackner Susan G, Prittie Jennifer

机构信息

Department of Emergency and Critical Care Medicine, Animal Medical Center, New York, NY 10065, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):77-89. doi: 10.1111/j.1476-4431.2009.00489.x.

Abstract

OBJECTIVE

To review and summarize current information regarding epidemiology, pathogenesis, and pathophysiology leading to the various clinical syndromes associated with canine babesiosis. Diagnosis, treatment, preventative strategies, and zoonotic implications are discussed.

ETIOLOGY

Babesiosis is caused by hemoprotozoa of the genus Babesia. Numerous species of Babesia exist worldwide. An increased incidence of babesiosis is described, especially in North America. The babesial organism spends the majority of its life cycle within the erythrocyte of the definitive host, resulting in hemolysis, with or without systemic complications.

DIAGNOSIS

Definitive diagnosis depends on direct visualization of the organism on blood smear or polymerase chain reaction. A positive serologic antibody test indicates exposure with or without active infection.

THERAPY

Antiprotozoal drugs, antimicrobials, and supportive care are the mainstays of babesiosis therapy.

PROGNOSIS

Prognosis depends on the severity of disease, which in turn depends on both organism and host factors. Clinical syndromes associated with a poorer prognosis include red biliary syndrome, acute renal failure, acute respiratory distress syndrome, neurologic dysfunction, acute pancreatitis, cardiac dysfunction, and hypoglycemia.

摘要

目的

回顾和总结目前有关犬巴贝斯虫病相关各种临床综合征的流行病学、发病机制和病理生理学的信息。讨论了诊断、治疗、预防策略及人畜共患病的影响。

病因

巴贝斯虫病由巴贝斯属的血液原虫引起。世界各地存在多种巴贝斯虫。巴贝斯虫病的发病率有所增加,尤其是在北美。巴贝斯虫生物体在终末宿主的红细胞内度过其大部分生命周期,导致溶血,可伴有或不伴有全身并发症。

诊断

确诊依赖于在血涂片上直接观察到病原体或聚合酶链反应。血清学抗体检测呈阳性表明曾接触过病原体,无论是否存在活动性感染。

治疗

抗原虫药物、抗菌药物及支持性治疗是巴贝斯虫病治疗的主要手段。

预后

预后取决于疾病的严重程度,而疾病严重程度又取决于病原体和宿主因素。预后较差的临床综合征包括红色胆汁综合征、急性肾衰竭、急性呼吸窘迫综合征、神经功能障碍、急性胰腺炎心脏功能障碍和低血糖症。

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