Department of Radiology, Yale New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, United States.
St. George's University School of Medicine, Grenada, West Indies.
Ticks Tick Borne Dis. 2018 Sep;9(6):1377-1382. doi: 10.1016/j.ttbdis.2018.06.004. Epub 2018 Jun 12.
Babesiosis is a relatively common tick-borne parasitic infection of erythrocytes primarily affecting the northeastern United States. Babesiosis' prevalence and presentation have earned it the monikers "malaria of the northeast" and "Nantucket fever". Clinical presentation ranges from asymptomatic infection to severe infection including acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulopathy (DIC) or death. Since 2008, there have been a number of reports of splenic rupture in patients with the disease. We seek to provide a further understanding of this process, with the report of a case of splenic rupture followed by a systematic review of the current literature. We found that 87% of splenic rupture secondary to babesiosis occurred in male patients who are otherwise healthy, with an average of 56 years. Computed tomography is a reliable mode of diagnosis, and hemoperitoneum is the most common imaging finding. Patients with splenic rupture due to human babesiosis were successfully treated by various management strategies, such as conservative non-operative approach, splenic artery embolization, and splenectomy. The modality of treatment depends on patient's clinical course and hemodynamic stability, although spleen conserving strategy should be considered first whenever possible.
巴贝斯虫病是一种相对常见的蜱传红细胞寄生虫感染，主要影响美国东北部。巴贝斯虫病的流行和表现使它获得了“东北部疟疾”和“楠塔基特热”的别名。临床表现从无症状感染到严重感染不等，包括急性呼吸窘迫综合征（ARDS）和弥散性血管内凝血（DIC）或死亡。自 2008 年以来，已有许多关于该疾病患者脾破裂的报告。我们旨在进一步了解这一过程，报告一例脾破裂病例，并对当前文献进行系统回顾。我们发现，87%的巴贝斯虫病继发脾破裂发生在健康的男性患者，平均年龄为 56 岁。计算机断层扫描是一种可靠的诊断方式，脾周积血是最常见的影像学表现。人类巴贝斯虫病引起的脾破裂患者通过各种治疗策略成功治疗，如保守非手术治疗、脾动脉栓塞和脾切除术。治疗方式取决于患者的临床过程和血流动力学稳定性，尽管只要有可能，就应首先考虑保留脾脏的策略。
