巴贝虫病相关性脾破裂：高发地区的病例系列。
Babesiosis-associated Splenic Rupture: Case Series From a Hyperendemic Region.
机构信息
Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence.
Division of Infectious Disease, Rhode Island Hospital and Alpert Medical School of Brown University, Providence.
出版信息
Clin Infect Dis. 2019 Sep 13;69(7):1212-1217. doi: 10.1093/cid/ciy1060.
BACKGROUND
Spontaneous splenic rupture is an increasingly reported complication of babesiosis and has been described as a severe complication.
METHODS
We performed a retrospective chart review in a high-prevalence area to identify 7 cases of babesiosis-related splenic rupture between 2014 and 2016.
RESULTS
Splenic rupture occurred in approximately 1% of babesiosis cases. Compared to cases without splenic rupture, these patients were younger (by >10 years), healthier (most with ≤1 comorbidity), had a lower degree of parasitemia (<10%), and were less likely to have end-organ dysfunction other than their splenic involvement.
CONCLUSIONS
Younger, healthier patients may be more prone to develop splenic rupture, as splenic histiocytes engage in more robust erythrophagocytosis, leading to pathological mechanical strain and rupture.
背景
自发性脾破裂是巴贝虫病越来越常见的并发症，被描述为一种严重的并发症。
方法
我们在高流行地区进行了回顾性图表审查，以确定 2014 年至 2016 年间发生的 7 例巴贝斯虫病相关脾破裂病例。
结果
脾破裂发生在约 1%的巴贝斯虫病病例中。与无脾破裂的病例相比，这些患者更年轻（超过 10 岁），更健康（大多数合并 1 种以下合并症），寄生虫血症程度较低（<10%），且除脾受累外，其他终末器官功能障碍的可能性较小。
结论
较年轻、更健康的患者可能更容易发生脾破裂，因为脾组织细胞更活跃地吞噬红细胞，导致病理性机械应变和破裂。
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