Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China.
State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China.
Infect Dis Poverty. 2023 Jul 13;12(1):67. doi: 10.1186/s40249-023-01111-1.
Human babesiosis is a worldwide disease caused by intraerythrocytic protozoa of the genus Babesia. It is transmitted by bites from ixodid ticks, and mechanically transmitted by blood transfusion. It is primarily treated with quinine and/or atovaquone, which are not readily available in China. In this study, we developed a novel treatment regimen involving doxycycline monotherapy in a patient with severe Babesia venatorum infection as an alternative therapeutic medication. The aim of our study is to provide a guidance for clinical practice treatment of human babesiosis.
A 73-year-old man who had undergone splenectomy and blood transfusion 8 years prior, presented with an unexplained fever, headache, and thrombocytopenia, and was admitted to the Fifth Medical Center of the PLA General Hospital. He was diagnosed with B. venatorum infection by morphological review of thin peripheral blood smears, which was confirmed by multi-gene polymerase chain reaction (PCR), and sequencing of the entire 18s rRNA and partial β-tubulin encoding genes, as well as isolation by animal inoculation. The doxycycline monotherapy regimen (peros, 0.1 g bisindie) was administered following pharmacological guidance and an effective outcome was observed. The patient recovered rapidly following the doxycycline monotherapy. The protozoan load in peripheral blood samples decreased by 88% in hematocrit counts after 8 days, and negative PCR results were obtained after 90 days of follow-up at the hospital. The treatment lasted for 3 months without any side effects or sequelae. The nine-month follow-up survey of the patient did not reveal any signs of recrudescence or anti-babesial tolerance.
We have reported a clinical case of successful doxycycline monotherapy for human babesiosis caused by B. venatorum, which provides an optional medical intervention for human babesiosis.
人巴贝斯虫病是一种由巴贝斯属的红细胞内原生动物引起的世界性疾病。它通过硬蜱叮咬传播，也可通过输血机械传播。主要用奎宁和/或阿托伐醌治疗，但在中国不易获得。在本研究中，我们开发了一种新的治疗方案，即在严重巴贝斯虫感染的患者中单独使用多西环素治疗，作为替代治疗药物。我们研究的目的是为人类巴贝斯虫病的临床治疗提供指导。
一名 73 岁男性，8 年前曾行脾切除术和输血，因不明原因发热、头痛和血小板减少而入院。通过薄外周血涂片的形态学检查诊断为巴贝斯虫感染，通过多基因聚合酶链反应（PCR）和 18s rRNA 及部分β-微管蛋白编码基因的测序，以及动物接种分离得到证实。根据药物学指导给予多西环素单药治疗（口服，0.1g 双羟萘酸），并观察到有效结果。多西环素单药治疗后，患者迅速康复。外周血样本中的原生动物负荷在 8 天后按红细胞压积计数下降 88%，90 天的医院随访中 PCR 结果为阴性。治疗持续 3 个月，无任何副作用或后遗症。对患者的 9 个月随访未发现复发或抗巴贝斯虫耐受的迹象。
我们报告了一例成功的多西环素单药治疗人巴贝斯虫病的临床病例，为人类巴贝斯虫病提供了一种可选的医疗干预措施。
