Brennan Meghan B, Herwaldt Barbara L, Kazmierczak James J, Weiss John W, Klein Christina L, Leith Catherine P, He Rong, Oberley Matthew J, Tonnetti Laura, Wilkins Patricia P, Gauthier Gregory M
Emerg Infect Dis. 2016 Nov;22(11):1869-76. doi: 10.3201/eid2211.151028.
Babesia microti, an intraerythrocytic parasite, is tickborne in nature. In contrast to transmission by blood transfusion, which has been well documented, transmission associated with solid organ transplantation has not been reported. We describe parasitologically confirmed cases of babesiosis diagnosed ≈8 weeks posttransplantation in 2 recipients of renal allografts from an organ donor who was multiply transfused on the day he died from traumatic injuries. The organ donor and recipients had no identified risk factors for tickborne infection. Antibodies against B. microti parasites were not detected by serologic testing of archived pretransplant specimens. However, 1 of the organ donor's blood donors was seropositive when tested postdonation and had risk factors for tick exposure. The organ donor probably served as a conduit of Babesia parasites from the seropositive blood donor to both kidney recipients. Babesiosis should be included in the differential diagnosis of unexplained fever and hemolytic anemia after blood transfusion or organ transplantation.
微小巴贝斯虫是一种红细胞内寄生虫，本质上通过蜱传播。与有充分文献记载的输血传播不同，与实体器官移植相关的传播尚未见报道。我们描述了2例肾移植受者在移植后约8周经寄生虫学确诊的巴贝斯虫病病例，器官供者因创伤性损伤死亡当日接受了多次输血。器官供者和受者均未发现蜱传播感染的危险因素。对存档的移植前标本进行血清学检测未检测到抗微小巴贝斯虫寄生虫的抗体。然而，器官供者的一名献血者在献血后检测血清呈阳性，并有蜱暴露的危险因素。器官供者可能充当了巴贝斯虫从血清阳性献血者到两名肾受者的传播渠道。巴贝斯虫病应纳入输血或器官移植后不明原因发热和溶血性贫血的鉴别诊断。
