41/73. Fatal pancarditis in a patient with coexistent lyme disease and babesiosis. Demonstration of spirochetes in the myocardium. A 66-year-old man developed fever, chills, myalgias, three erythematous skin lesions, and transient left eyelid lag. Because of persistent fever, he was hospitalized 4 weeks after the onset of disease; a peripheral blood smear showed babesia microti in 3% of his erythrocytes. Eighteen hours later, he died unexpectedly. autopsy showed pancarditis with a diffuse lymphoplasmacytic infiltrate, and spirochetes were found in the myocardium. Antibody titers to both the lyme disease spirochete borrelia burgdorferi and babesia microti were elevated. The finding of spirochetes in the myocardium and the elevated antibody titers to borrelia burgdorferi suggest that the patient died from cardiac involvement of lyme disease. ( info) |
42/73. Neurologic complications following the treatment of human babesia microti infection with diminazene aceturate. A 65-year-old man infected with babesia microti failed to respond to therapy with oral chloroquine phosphate. He was then successfully dreated with diminazene aceturate, an experimental anti-protozoal agent. After his recovery from babesiosis, the patient developed acute idiopathic polyneuritis (Landry-guillain-barre syndrome), which was probably related to his diminazene therapy. ( info) |
43/73. Failure of chloroquine in human babesiosis (babesia microti): case report and chemotherapeutic trials in hamsters. The failure of a 3-week course of chloroquine to eliminate an infection of babesia microti acquired on Martha's Vineyard led to tests of selected drugs in hamsters infected with the strain from this patient. The results showed response to several antitrypanosomal drugs (pentamidine and 4,4'-diazoaminobenzamidine) but not to antimalarial drugs (chloroquine, sulfadiazine, and pyrimethamine). ( info) |
44/73. babesiosis in asplenic hosts. A case of babesiosis in an asplenic individual is reported. A course characterized by fever, haemolysis, hepatitis, depressed mental status and non-cardiac pulmonary oedema was observed. Studies performed on the patient's lymphocytes revealed profound depression in mitogenic responses during her acute disease which returned to normal with recovery. serum factor(s) were implicated in causing these changes. review of the literature on babesiosis in asplenic hosts revealed European patients with disease caused by bovine species of Babesia are at significantly higher risk of a fatal outcome than North Americans with disease caused by murine species. ( info) |
| babesiosis is a malaria-like illness due to intraerythrocytic protozoan parasites. To the authors' knowledge, this unusual disease has not previously been described in a pregnant woman. Herein is reported the case of a gravid woman with an intact spleen who developed infection with babesia microti in the fifth month of gestation. Her illness resolved following supportive care only, and evidence of transmission of disease to the fetus was not found. ( info) |
46/73. Self-limited babesiosis in a splenectomized child. This report describes a self-limited babesia infection in a splenectomized child with hereditary spherocytosis. This is the first report of infectious babesiosis in a child and the second case of babesiosis reported on Cape Cod. The infection manifested itself 6 weeks after a 4-hour exposure to Nantucket. hemolysis lasted only 4 days and resolved without specific treatment. parasitemia was documented after resolution of symptoms. ( info) |
47/73. adult respiratory distress syndrome in babesiosis. A patient is described who contracted transfusion-induced babesiosis, and later developed acute respiratory distress syndrome (ARDS) as a fatal complication. ARDS has been reported in patients with plasmodium falciparum malaria, but to our knowledge has not been observed as a complication of babesiosis. ( info) |
48/73. Morphologic and clinical observations in human infection with babesia microti. On admission to the hospital, a splenectomized man was found to have 85% of his erythrocytes parasitized by babesia microti. His extensive parasitemia allowed for direct study of the morphology and ultrastructure of this organism as it appears in human infection; the need for animal inoculation and rescue techniques was thus eliminated. Positive characteristics (other than the tetrad form) that are diagnostic for babesiosis were identified. By transmission and scanning electron microscopy, parasite-induced changes in the erythrocyte membrane were observed; these alterations may explain the hemolysis seen in babesiosis. Factors that may have allowed the patient to sustain such high-level parasitemia are considered. The experience with this patient confirms that exchange transfusion is a reliable, rapid method for reduction of the parasite load in serious infection with B microti. ( info) |
| Two persons who had been splenectomized later contracted babesiosis, one on Cape Cod and one near Islip, Long Island, areas where human cases of babesiosis had not been previously identified. One of the patients received pentamidine, but parasitemia persisted after therapy. No deaths have been recorded for persons who had had splenectomies and were later infected with babesia microti. Until more effective therapy is available, such patients should be treated conservatively. ( info) |
50/73. Red cell exchange: treatment of babesiosis in a splenectomized patient. A splenectomized woman with a history of hepatic disorders was diagnosed as having babesiosis. The patient was unsuccessfully treated with chloroquine and with pentamidine isothionate. A parasitemia of 15 per cent was reduced permanently to less than 1 per cent after a red blood cell exchange, but a low grade parasitemia still existed 10 months after onset. On two separate occasions, the patient was found to have selective iga deficiency, a reduction of T lymphocytes, and a reduction in function of both T and B lymphocytes. This case represents the highest and the longest duration of parasitemia ever recorded. It reports the first use of pentamidine and red blood cell exchange transfusion in human babesiosis, one of the earliest diagnosed cases of babesiosis, and the most severe clinical case to survive. ( info) |