切换至 "中华医学电子期刊资源库"

中华实验和临床感染病杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 519 -523. doi: 10.3877/cma.j.issn.1674-1358.2019.06.012

所属专题: 经典病例 经典病例 文献

病例报告

北京地区人巴贝虫感染者一例
王鹤1,(), 齐文杰1   
  1. 1. 100050 北京,首都医科大学附属北京友谊医院感染内科
  • 收稿日期:2019-01-13 出版日期:2019-12-15
  • 通信作者: 王鹤

A case report of human Babesia infection in Beijing

He Wang1,(), Wenjie Qi1   

  1. 1. Department of Infection Medicine, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
  • Received:2019-01-13 Published:2019-12-15
  • Corresponding author: He Wang
  • About author:
    Corresponding author: Wang He, Email:
引用本文:

王鹤, 齐文杰. 北京地区人巴贝虫感染者一例[J]. 中华实验和临床感染病杂志(电子版), 2019, 13(06): 519-523.

He Wang, Wenjie Qi. A case report of human Babesia infection in Beijing[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(06): 519-523.

目的

探讨人感染巴贝虫的临床特征、实验室检查及治疗方法。

方法

回顾性分析首都医科大学附属北京友谊医院感染内科2017年8月28日收治的1例人感染巴贝虫并诱发噬血细胞综合征患者的病例资料和诊疗过程。

结果

患者长期居住于北京,无疫区疫水等接触史,但有河北农村生产劳作史,随后出现发热、口渴、多尿、水肿并伴有白细胞、红细胞、血小板计数减低,黄疸,血钠、血氯下降等;血涂片及骨髓涂片:可见红细胞胞内体,疑似巴贝虫感染;及时给予患者相应抗菌药物,加用克林霉素后患者所有症状消失及实验室指标恢复至正常。

结论

目前虽报道巴贝虫在我国北方蒙古边境、云南、东南沿海发病,但京津冀地区仍有部分散发病例,故尚需警惕,适时血涂片至关重要;巴贝虫感染亦可诱发噬血细胞综合征,易误诊为血液系统疾病,去除原发病是治疗关键。

Objective

To investigate the clinical characteristics, laboratory examination and treatment of Babella infection.

Methods

Data of diagnosis and treatment of a patient infected with Babella and induced hemophagocytic syndrome in Beijing Friendship Hospital, Capital Medical University on August 28th, 2017 were analyzed, retrospectively.

Results

The patient lived in Beijing and had no contact history of epidemic water, but had a history of labor in rural areas of Hebei Province, following by fever, thirst, polyuria, edema accompanied by decreased white blood cells, red blood cells, platelet count, blood sodium, jaundice and blood chlorine. Blood smear and bone marrow smear showed that erythrocyte endosomes and suspected Babesia infection. After timely administration of antibiotics and clindamycin, all the symptoms disappeared and laboratory indexes of the patient restored.

Conclusions

Although the disease is reported in Northern Mongolian border, Yunnan and Southeastern coast of China, but there are still some sporadic cases in Beijing-Tianjin-Hebei region, so we still should be vigilant about the disease, which is easy to be misdiagnosed as hematological diseases and timely blood smear is very important.

图1 红细胞内体吉姆萨Giemsa染色(× 1 000)
[1]
Pérez de León AA, Strickman DA, Knowles DP, et al. One health approach to identify research needs in bovine and human babesioses: workshop report[J]. Parasit Vectors,2010,3(1):36.
[2]
Scott JD, Scott CM. duncani has widespread distribution across Canada[J]. Healthcare (Basel),2018,6(2):49.
[3]
Tonnetti L, Eder AF, Dy B, et al. Transfusion-transmitted Babesia microti identified through hemovigilanee[J]. Transfusion, 2009,49(12):2557-2563.
[4]
Haapasalo K, Suomalainen P, Sukura A, et al. Fatal babesiosis in man, Finland, 2004[J]. Emerg Infect Dis,2010,16(7):1116-1118.
[5]
杨宇,高艳菲,曹旸, 等. 内蒙古满洲里口岸地区2012-2014年蜱携带病原体调查[J]. 中国媒介生物学及控制杂志,2018,29(2):147-150.
[6]
胡刚,方志强,王建成, 等. 中国-尼泊尔边境樟木口岸蜱类携带病原体调查研究[J]. 寄生虫与医学昆虫学报,2016,23(3):164-168.
[7]
欧阳榕,陈朱云,林耀莹, 等. 福建省1例人巴贝虫病的诊断与鉴定[J]. 中国人兽共患病学报,2018,34(5):108-110.
[8]
Paparone P, Paparone PW. Variable clinical presentations of babesiosis[J]. Nurse Pract,2018,43(10):48-54.
[9]
陈小光,李学荣,吴忠道. 巴贝虫和巴贝虫病的研究进展[J]. 国际医学寄生虫病杂志,2012,39(1):45-49.
[10]
Herwaldt B, Persing DH, Prrcigout EA, et al. A fatal case of babesiosis in Missouri: identification of another piroplasm that infects humans[J]. Ann Intern Med,1996,124(7):643-650.
[11]
Rożej-Bielicka W, Stypułkowska-Misiurewicz H, Gołąb E. Human babesiosis[J]. Przegl Epidemiol,2015,69(3):489-94, 605-608.
[12]
Primus S, Akoolo L, Schlachter S, et al. Screening of patient blood samples for babesiosis using enzymatic assays[J]. Ticks Tick Borne Dis,2018,9(2):302-306.
[13]
Herman JH, Ayache S, Olkowska D. Autoimmunity in transfusion babesiosis: A spectrum of clinical presentations[J]. J Clin Apher,2010,25(6):358-361.
[14]
Annoscia G, Latrofa MS, Cantacessi C, et al. A new PCR assay for the detection and differentiation of Babesia canis and Babesia vogeli[J]. Ticks Tick Borne Dis,2017,8(6):862-865.
[15]
Lempereur L, Shiels B, Heyman P, et al. A retrospective serological survey on human babesiosis in Belgium[J]. Clin Microbiol Infect,2015,21(1):96. e1-7.
[16]
Szczepi0rk0wski ZM, Winters JL, Bandarenko N, et al. Guidelines on the use of therapeutic apheresis in clinical practice evidencebased approach from the Apheresis Applications Committce of the American Society for Apheresis[J]. J Clin Apher,2010,25(3):83-177.
[17]
Slade DJ. Lees GE, Berridge BR et al. Resolution of a proteinuric nephropathy associated with Babesia gibsoni infection in a dog[J]. J Am Anim Hosp Assoc,2011,47(6):e138-144.
[18]
Luciano RL, Moeckel G, Palmer M, et al. Babesiosis-induced acute kidney injury with prominent urinary macrophages[J]. Am J kidney Dis,2013,2(4):801-805.
[19]
Sriwijitalai W, Wiwanitkit V. Human babesiosis, renal failure, and dialysis: A summary and comment on forgotten disease[J]. Saudi J Kidney Dis Transpl,2018,29(2):481-482.
[20]
潘智华,郑辰,陈家旭, 等. 田鼠巴贝西虫感染致宿主血小板活化初步研究[J]. 中国媒介生物学及控制杂志,2018,29(1):24-27.
[21]
雷永良,王晓光,姚立农, 等. 人感染巴贝西原虫个案分析[J]. 中国卫生检验杂志,2012(3):651-652.
[1] 肖梦瑶, 辛小娟. 成人EB病毒相关噬血细胞综合征的危险因素[J]. 中华实验和临床感染病杂志(电子版), 2022, 16(02): 73-81.
[2] 王鹤, 胡岚, 方媚, 栗绍刚, 王超, 齐文杰. 北京地区输入性人粒细胞无形体病患者一例[J]. 中华实验和临床感染病杂志(电子版), 2022, 16(01): 60-64.
[3] 孙娜, 陈志海. 发热伴血小板减少综合征患者的血液及免疫系统损伤[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(06): 538-542.
[4] 王中涛, 熊勇, 邓莉平, 田素芳, 陈飞. 人类获得性免疫缺陷综合征合并播散性马尔尼菲青霉菌病和噬血细胞综合征一例并文献复习[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(03): 307-312.
[5] 王霞, 郝一玥, 高上兰, 罗静, 徐静. 噬血细胞综合征并发社区获得性肺炎救治成功一例[J]. 中华肺部疾病杂志(电子版), 2023, 16(01): 141-142.
[6] 高荣青, 王志民, 张辉, 陈璐, 李元涛. 肛周坏死性筋膜炎并噬血细胞综合征一例报道[J]. 中华结直肠疾病电子杂志, 2019, 08(04): 411-412.
[7] 李文波. 细胞因子风暴及其在消化道疾病中的作用[J]. 中华消化病与影像杂志(电子版), 2022, 12(01): 1-3.
[8] 辛彩焕, 熊辉. 非疫区36例布鲁菌病患者的临床特征及诊疗分析[J]. 中华临床医师杂志(电子版), 2023, 17(9): 927-931.
[9] 李碧婷, 王惠丽, 唐玲玲, 罗欣. 儿童脓毒症合并噬血细胞综合征诊断学特征分析[J]. 中华诊断学电子杂志, 2022, 10(04): 229-233.
阅读次数
全文


摘要