Mareedu Neeharik, Schotthoefer Anna M, Tompkins Jason, Hall Matthew C, Fritsche Thomas R, Frost Holly M
Marshfield Clinic Health System, Marshfield, Wisconsin.
Marshfield Clinic Research Institute, Marshfield, Wisconsin.
Am J Trop Med Hyg. 2017 Oct;97(4):1218-1225. doi: 10.4269/ajtmh.17-0146. Epub 2017 Jul 19.
Babesiosis is an emerging tick-borne disease transmitted by the hard tick , which also transmits Lyme disease. Better gradation of prognostic indicators are needed to determine which patients may develop serious complications requiring hospitalization, and to provide early guidance on appropriate therapy. In this study, we evaluated 128 patients with smear or real time polymerase chain reaction-confirmed infections over a period of 16 years. Patients with asplenia or immunocompromising conditions were more likely to have severe infection ( < 0.01), require hospitalization ( < 0.01), or receive prolonged courses of antimicrobials ( < 0.01). Nausea or vomiting ( < 0.01) and diarrhea ( < 0.01) along with hyperbilirubinemia ( < 0.01) were predictive of severe infection, hospitalization, and prolonged antimicrobial therapy. Patients with concurrent Lyme disease were less likely to require hospitalization and had similar severity of disease and length of antibiotic treatment compared with those without Lyme disease.
巴贝斯虫病是一种新出现的蜱传播疾病，由硬蜱传播，硬蜱也传播莱姆病。需要更好地分级预后指标，以确定哪些患者可能出现需要住院治疗的严重并发症，并为适当治疗提供早期指导。在本研究中，我们在16年的时间里评估了128例经涂片或实时聚合酶链反应确诊感染的患者。无脾或免疫功能低下的患者更有可能发生严重感染（<0.01）、需要住院治疗（<0.01）或接受延长疗程的抗菌药物治疗（<0.01）。恶心或呕吐（<0.01）、腹泻（<0.01）以及高胆红素血症（<0.01）可预测严重感染、住院治疗和延长抗菌药物治疗。与未患莱姆病的患者相比，同时患有莱姆病的患者需要住院治疗的可能性较小，疾病严重程度和抗生素治疗时长相似。
