Cases reported "Babesiosis"

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1/10. A cluster of transfusion-associated babesiosis cases traced to a single asymptomatic donor.

    CONTEXT: The risk of acquiring babesiosis by blood transfusion is largely unknown since in areas where it is endemic it is often an asymptomatic infection. OBJECTIVE: To investigate and treat a cluster of blood transfusion-associated babesiosis cases. DESIGN: Case series and epidemiologic investigation. SETTING: Urban inner-city hospital. patients: Six persons who received babesia microti-infected blood components from a donor. MAIN OUTCOME MEASURE: diagnosis and successful therapy of babesiosis following transfusion. RESULTS: Six individuals (1 adult, 1 child, and 4 neonates) were exposed to products from a single blood donation by an asymptomatic Babesia-infected donor. Three of the 6 exposed patients became parasitemic. polymerase chain reaction testing, animal inoculation studies, and indirect immunofluorescent antibody testing were used to confirm the presence of babesia microti in the donor's blood and to establish the presence of infection in 3 of the 6 recipients. The 3 infected recipients and 1 additional recipient were treated without incident. CONCLUSION: physicians should consider babesiosis in the differential diagnosis of a febrile hemolytic disorder after blood transfusion. Prompt diagnosis is important since babesiosis is responsive to antibiotic therapy and, untreated, can be a fatal disease in certain risk groups.
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2/10. 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.
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3/10. A fatal case of human babesiosis in portugal: molecular and phylogenetic analysis.

    We report the first case of human babesiosis in portugal. A 66-year-old splenectomized man was admitted to a Lisbon hospital after 1 week of fever, abdominal pain, anorexia and nausea. A high parasitaemia (30%) of Babesia parasites was found in Giemsa-stained blood smears and, despite treatment, the patient died several weeks later of renal failure. Ethylenediaminetetraacetic acid blood samples were processed for polymerase chain reaction (PCR) and reverse line blot hybridization to confirm and characterize the Babesia infection. The amplified PCR product was cloned and subsequently sequenced. Molecular analysis showed that the infection was caused by Babesia divergens and that other blood parasites were not involved. Phylogenetic analysis showed that the 18 S ribosomal rna gene sequence was similar to three other European isolates of B. divergens. In view of the high risk for splenectomized individuals, strict measures should be taken to avoid tick bites.
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4/10. 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.
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keywords = borreliosis
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5/10. Molecular characterization of a non-Babesia divergens organism causing zoonotic babesiosis in europe.

    In europe, most reported human cases of babesiosis have been attributed, without strong molecular evidence, to infection with the bovine parasite Babesia divergens. We investigated the first known human cases of babesiosis in italy and austria, which occurred in two asplenic men. The complete 18S ribosomal rna (18S rRNA) gene was amplified from specimens of their whole blood by polymerase chain reaction (PCR). With phylogenetic analysis, we compared the dna sequences of the PCR products with those for other Babesia spp. The dna sequences were identical for the organism from the two patients. In phylogenetic analysis, the organism clusters with B. odocoilei, a parasite of white-tailed deer; these two organisms form a sister group with B. divergens. This evidence indicates the patients were not infected with B. divergens but with an organism with previously unreported molecular characteristics for the 18S rRNA gene.
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6/10. Neonatal babesiosis: case report and review of the literature.

    A case of transfusion-associated neonatal babesiosis is presented. jaundice, hepatosplenomegaly, anemia and conjugated hyperbilirubinemia developed in this preterm infant. The diagnosis was eventually made by blood smear, serology and polymerase chain reaction. The patient was treated with clindamycin and quinine and made a favorable recovery. Of neonatal babesiosis reported in the literature, 9 other cases are reviewed, including 6 that were transfusion-associated, 2 congenital and 2 tick transmitted.
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7/10. Human babesiosis.

    OBJECTIVE: To describe a case of human babesiosis and review the literature on the disease. MATERIAL AND methods: We describe a 62-year-old man with babesiosis, outline his clinical course and response to therapy, and discuss the use of the polymerase chain reaction for the diagnosis and monitoring of the infection. RESULTS: The onset of the disease was insidious, with fatigue, fever, weight loss, intermittently discolored urine, and anemia. Computed tomography of the abdomen revealed a small, shrunken spleen with an irregular border. With treatment, the symptoms gradually resolved. Although peripheral blood smears were negative soon after therapy, babesia microti dna was detected by polymerase chain reaction 53 days after initial examination. CONCLUSION: The development of improved methods for diagnosis, including indirect immunofluorescent antibody assays and the polymerase chain reaction, provides more sensitive detection of the parasitemia associated with babesiosis. Use of these methods may help to delineate the complete clinical spectrum of this infection and its geographic distribution in the united states.
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keywords = lyme
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8/10. Infection with a babesia-like organism in northern california.

    BACKGROUND. Human babesiosis is a tick-transmitted zoonosis associated with two protozoa of the family Piroplasmorida: babesia microti (in the united states) and B. divergens (in europe). Recently, infection with an unusual babesia-like piroplasm (designated WA1) was described in a patient from washington State. We studied four patients in california who were identified as being infected with a similar protozoal parasite. All four patients had undergone splenectomy, three because of trauma and one because of Hodgkin's disease. Two of the patients had complicated courses, and one died. methods. Piroplasm-specific nuclear small-subunit ribosomal dna was recovered from the blood of the four patients by amplification with the polymerase chain reaction. The genetic sequences were compared with those of other known piroplasm species. Indirect immunofluorescent-antibody testing of serum from the four patients and from other potentially exposed persons was performed with WA1 and babesia antigens. RESULTS. Genetic sequence analysis showed that the organisms from all four patients were nearly identical. Phylogenic analysis showed that this strain is more closely related to a known canine pathogen (B. gibsoni) and to theileria species than to some members of the genus babesia. serum from three of the patients was reactive to WA1 but not to B. microti antigen. Serologic testing showed WA1-antibody seroprevalence rates of 16 percent (8 of 51 persons at risk) and 3.5 percent (4 of 115) in two geographically distinct areas of northern california. CONCLUSIONS. A newly identified babesia-like organism causes infections in humans in the western united states. The clinical spectrum associated with infection with this protozoan ranges from asymptomatic infection or influenza-like illness to fulminant, fatal disease.
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9/10. A fatal case of babesiosis in missouri: identification of another piroplasm that infects humans.

    OBJECTIVE: To characterize the etiologic agents (MO1) of the first reported case of babesiosis acquired in missouri. DESIGN: Case report, serologic testing, animal inoculations, and molecular studies. SETTING: Southeastern missouri. PATIENT: A 73-year-old man who had had a splenectomy and had a fatal case of babesiosis. MEASUREMENTS: serum specimens from the patient were assayed by indirect immunofluorescent antibody testing and immunoprecipitation for reactivity with antigens from various Babesia species. Whole blood obtained from the patient before treatment was inoculated into hamsters and jirds and into calves and bighorn sheep that had had splenectomy and were immunosuppressed with dexamethasone. Piroplasm-specific nuclear small-subunit ribosomal dna was recovered from the patient's blood by using broad-range amplification with the polymerase chain reaction; a 144 base-pair region of the amplification product was sequenced; and phylogenetic analysis was done to compare MO1 with various Babesia species. RESULTS: Indirect immunofluorescent antibody testing showed that the patient's serum had strong reactivity with Babesia divergens, which causes babesiosis in cattle and humans in europe, but that it had minimal reactivity with B. microti and WA1, which are the piroplasms previously known to cause zoonotic babesiosis in the united states. Immunoprecipitations showed that MO1 is more closely related to B. divergens than to B. canis (a canine parasite). None of the experimentally inoculated animals became demonstrably parasitemic. Phylogenetic analyses, after dna sequencing, showed that MO1 is most closely related to B. divergens (100% similarity). CONCLUSIONS: Although MO1 is probably distinct from B. divergens, the two share morphologic, antigenic, and genetic characteristics; MO1 probably represents a Babesia species not previously recognized to have infected humans. Medical personnel should be aware that patients in the united states can have life-threatening babesiosis even though they are seronegative to B. microti and WA1 antigen.
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10/10. coinfection with babesia microti and borrelia burgdorferi in a western wisconsin resident.

    A 68-year-old woman, who had not traveled outside of western wisconsin, was hospitalized after 4 weeks of chills, fevers, myalgias, neuralgias in her right arm, and pain in the right upper quadrant of her abdomen. physical examination revealed hepatosplenomegaly, and laboratory studies showed anemia, thrombocytopenia, increased aspartate transaminase level, and microscopic hematuria. Wright's stain of a blood smear revealed intraerythrocytic organisms consistent with Babesia species. A polymerase chain reaction of whole blood specimens along with an increased serologic titer confirmed the diagnosis of babesia microti. Indirect immunofluorescent antibody serology and Western blot analysis revealed a simultaneous infection with borrelia burgdorferi. coinfection with B. microti and B. burgdorferi may occur in endemic areas where both organisms are carried by the same tick vector, ixodes scapularis. The intensity and duration of illness seem to be greatest in patients with concurrent infection.
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