Department of Medicine, University of Minnesota, Minneapolis, USA.
Am J Med. 2011 Sep;124(9):800-5. doi: 10.1016/j.amjmed.2011.03.009. Epub 2011 Jun 16.
Babesiosis is a tick- and transfusion-borne disease caused by intraerythrocytic Babesia parasites. In 2009, a 61-year-old Minnesota woman with chronic lymphocytic leukemia and a history of recent chemotherapy and numerous blood transfusions for gastrointestinal bleeding became febrile and anemic 12 days postsplenectomy. Babesia were visualized on blood smears, confirmed by polymerase chain reaction as B. microti. She developed respiratory failure despite initiation of clindamycin and quinine, and required 12 weeks of azithromycin and atovaquone before blood smear and polymerase chain reaction findings were negative. Serologic evidence of B. microti infection was identified in 1 associated blood donor and 1 other recipient of that donor's blood. Babesia infection can be asymptomatic or cause mild to fulminant disease resulting in multiorgan failure or death. Patients with advanced age, asplenia, or other immune compromise are at risk for severe babesiosis and may require prolonged treatment to eradicate parasitemia. Incidence of transfusion-transmitted babesiosis has increased over the past decade.
巴贝虫病是一种由红细胞内巴贝虫寄生虫引起的蜱传和输血传播疾病。2009 年，明尼苏达州一位 61 岁女性患有慢性淋巴细胞白血病，近期有化疗史，因胃肠道出血接受了多次输血，在脾切除术后 12 天出现发热和贫血。血涂片上可见巴贝斯虫，聚合酶链反应证实为微小巴贝斯虫。尽管开始使用克林霉素和奎宁，但她仍出现呼吸衰竭，需要 12 周的阿奇霉素和阿托伐醌治疗，血涂片和聚合酶链反应结果才转为阴性。在 1 名相关献血者和另 1 名接受该献血者血液的受血者中发现了微小巴贝斯虫感染的血清学证据。年龄较大、脾切除或其他免疫功能受损的患者有发生严重巴贝虫病的风险，可能需要延长治疗以消除寄生虫血症。过去十年中，输血传播性巴贝虫病的发病率有所增加。
