Williams George, Tatem Luis, Ghosh Kuldeep, Pascual Arturo G, Kapinos Piotr, Mordue Dana G, El Khoury Marc Y
Division of Infectious Diseases, Departments of Medicine, Westchester Medical Center, Valhalla, NY 10595, USA.
Department of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY 10595, USA.
Pathogens. 2025 Apr 12;14(4):376. doi: 10.3390/pathogens14040376.
Babesiosis is an emerging tick-borne illness, and pulmonary manifestations have not been well described previously. This is a single-center, retrospective study of hospitalized adults with confirmed babesiosis at Westchester Medical Center (Valhalla, NY, USA) from 2006 to 2023. Descriptive analysis was used to summarize the demographic and clinical data. Logistic regression was used to determine factors associated with severe disease and mortality. A total of 147 cases were reviewed; 63 were severe, 41 were admitted to the intensive care unit, and ten died. Respiratory symptoms were observed in 42% of cases (cough, dyspnea, oxygen supplementation, respiratory failure). A total of 55 patients had an abnormal chest radiograph (infiltrates, pleural effusions), and 75% of severe cases had parasitemia ≥ 10%. Factors associated with severe cases included age ≥ 70 years, severe dyspnea, radiographic abnormalities, white blood cell count > 5000 cells/dL, hemoglobin 8 g/dL or less, and increased creatinine. Lyme seropositivity was common (28%). Exchange transfusion did not correlate with outcome. Increased mortality was more likely in patients 70 years or older or in those having any of the following: encephalopathy, acute kidney injury, severe dyspnea on admission, abnormal chest radiograph, and requiring intubation. In conclusion, pulmonary symptoms including abnormal chest radiograph are not uncommon in babesiosis and are associated with worse outcomes.
巴贝斯虫病是一种新出现的蜱传播疾病，此前对其肺部表现的描述并不充分。这是一项在美国纽约州瓦尔哈拉市韦斯特切斯特医疗中心进行的单中心回顾性研究，研究对象为2006年至2023年期间确诊为巴贝斯虫病的住院成人。采用描述性分析来总结人口统计学和临床数据。使用逻辑回归来确定与严重疾病和死亡率相关的因素。共审查了147例病例；其中63例病情严重，41例被收入重症监护病房，10例死亡。42%的病例出现呼吸道症状（咳嗽、呼吸困难、吸氧、呼吸衰竭）。共有55例患者胸部X光片异常（浸润影、胸腔积液），75%的重症病例寄生虫血症≥10%。与重症病例相关的因素包括年龄≥70岁、严重呼吸困难、影像学异常、白细胞计数>5000个/微升、血红蛋白≤8克/分升以及肌酐升高。莱姆病血清学阳性很常见（28%）。换血治疗与预后无关。70岁及以上患者或有以下任何一种情况的患者死亡率更高：脑病、急性肾损伤、入院时严重呼吸困难、胸部X光片异常以及需要插管。总之，包括胸部X光片异常在内的肺部症状在巴贝斯虫病中并不少见，且与更差的预后相关。
