1/4. Transverse myelitis secondary to coexistent lyme disease and babesiosis.OBJECTIVE: To describe transverse myelitis secondary to coexistent lyme disease and babesiosis. METHOD: Case report. BACKGROUND: A 74-year-old man presented with rapid onset of weakness, numbness, and tingling in his legs, with symptoms ascending to his hands and forearms within days. He recalled an insect bite to his scapular area 2 weeks earlier. FINDINGS: T2-weighted magnetic resonance imaging demonstrated diffuse hyperintensity from T1 through T12. Western blot and enzyme-linked immunosorbent assay identified infection with borrelia burgdorferi, the spirochete responsible for lyme disease. Giemsa-stained blood smears identified ring forms later recognized by polymerase chain reaction as babesia microti, the piroplasm responsible for babesiosis. Initial examination revealed C7 motor and T3 sensory complete tetraplegia, with recovery to T4 paraplegia by 2 months. CONCLUSION: The history, physical examination, imaging, and serologic studies were consistent with transverse myelitis related to lyme disease and babesiosis. The severity and permanence of this patient's deficits were greater than those reported in the majority of previous cases of transverse myelitis due to lyme disease alone, suggesting a possible role for coinfection with babesiosis.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
2/4. Coexistence of antibodies to tick-borne agents of babesiosis and Lyme borreliosis in patients from Cotia county, State of Sao Paulo, brazil.This paper reports a case of coinfection caused by pathogens of lyme disease and babesiosis in brothers. This was the first case of borreliosis in brazil, acquired in Cotia County, State of S o Paulo, brazil. Both children had tick bite history, presented erythema migrans, fever, arthralgia, mialgia, and developed positive serology (ELISA and Western-blotting) directed to borrelia burgdorferi G 39/40 and babesia bovis antigens, mainly of IgM class antibodies, suggestive of acute disease. Also, high frequencies of antibodies to B. bovis was observed in a group of 59 Brazilian patients with Lyme borreliosis (25.4%), when compared with that obtained in a normal control group (10.2%) (chi-square = 5.6; p < 0.05). Interestingly, both children presented the highest titers for IgM antibodies directed to both infective diseases, among all patients with Lyme borreliosis.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
3/4. babesia microti infection in europe.The majority of babesia infections in europe are life-threatening and caused by Babesia divergens and B. bovis. Although babesia microti has been detected in ticks from switzerland, few if any cases of babesiosis have been caused by B. microti. This first reported case, diagnosed by serology, dna detection, and microscopy, is additionally interesting because there appears to be coinfection with the lyme disease organism, borrelia burgdorferi.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |
4/4. Treatment of babesiosis by red blood cell exchange in an hiv-positive, splenectomized patient.babesiosis is a malaria-like parasitic disease causing subclinical or mild illness in most cases. Splenectomized patients, however, may experience a more severe course. Although generally responsive to antibiotic therapy, several cases of severe babesiosis refractory to appropriate antibiotic therapy have been reported to respond promptly and dramatically to red blood cell (RBC) exchange transfusion. Although the role of hiv coinfection in babesiosis is uncertain, two previously reported cases raise a concern that it may predispose to a more severe clinical course. We report a third case of severe babesiosis in an hiv-positive splenectomized man, following travel to an endemic area. Antibiotic therapy, though initially effective, ultimately failed to prevent severe disease. RBC exchange transfusion resulted in prompt clinical improvement, which has been sustained during 26 months of follow-up. Although the patient has since developed various sequelae of hiv infection, including disseminated Kaposi's sarcoma, CMV retinitis, and enteritis, there has been no recurrence of observable parasitemia. In severe babesiosis, RBC exchange transfusion, combined with appropriate antibiotic therapy, appears to be a rapidly effective therapeutic modality which can induce sustained remissions.- - - - - - - - - - ranking = 1keywords = coinfection (Clic here for more details about this article) |