Shahid Mahum, Wechsler Brendan, Parameswaran Vinod, Diaz Mark Anthony
University of South Dakota Sanford School of Medicine, Vermillion, SD, USA.
University of Nebraska Medical Center, Department of Radiology, Omaha, NE, USA.
Case Rep Infect Dis. 2024 May 14;2024:7168928. doi: 10.1155/2024/7168928. eCollection 2024.
We report a challenging case of persistent relapsing babesiosis in an immunocompromised host that was successfully managed with atovaquone-proguanil (Malarone). Malignant B-cell transformation and immunosuppressants, such as rituximab, deplete normal B-cells which normally produce antibodies to combat Babesia infection. Treatment can be prolonged and challenging in immunocompromised hosts. Atovaquone-proguanil (Malarone) is a novel therapy that can be used as part of a salvage regimen in case antimicrobial resistance or failure exists. Weighing the risks and benefits of continuing cancer therapy treatment or reducing the level of immunosuppression may aid in treatment. These are just as important as the choice of antimicrobial therapy for effective treatment and eradication of Babesia infection, especially in immunocompromised hosts.
我们报告了一例免疫功能低下宿主中持续复发的巴贝斯虫病的挑战性病例，该病例通过使用阿托伐醌-氯胍（Malarone）成功得到治疗。恶性B细胞转化以及诸如利妥昔单抗等免疫抑制剂会消耗正常的B细胞，而正常B细胞通常会产生抗体来对抗巴贝斯虫感染。在免疫功能低下的宿主中，治疗可能会延长且具有挑战性。阿托伐醌-氯胍（Malarone）是一种新型疗法，可在存在抗菌药物耐药性或治疗失败的情况下用作挽救方案的一部分。权衡继续进行癌症治疗或降低免疫抑制水平的风险和益处可能有助于治疗。这些与选择抗菌疗法对于有效治疗和根除巴贝斯虫感染同样重要，尤其是在免疫功能低下的宿主中。
