First documented case of human babesiosis in Sweden.
A 34-year-old splenectomized man presented with fever, myalgia and dysuria. His condition rapidly deteriorated, he became anuric and developed severe haemolytic anaemia, thrombocytopenia and fibrinolysis. Peripheral blood smears revealed intra-erythrocytic parasites consistent with Babesia divergens in 40% of the erythrocytes. The diagnosis was confirmed by gerbil inoculation and by a significant rise in antibody titer. Blood exchange transfusion reduced the number of babesia infected erythrocytes to 1%. Parenteral therapy with a combination of quinine and clindamycin eradicated parasitaemia after 10 days of treatment and the patient rapidly improved. Renal failure necessitated haemodialysis for one month, whereafter the patient made a full recovery. Human babesiosis is a rare disease, but with a potential fatal outcome and should be considered as a diagnostic alternative in splenectomized and otherwise immunocompromised individuals with severe febrile illnesses.
Uhnoo
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I
Department of Infectious Diseases, University Hospital, Uppsala, Sweden.
Cars
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O
Christensson
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Nyström-Rosander
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C
D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D001403:Babesia / Q000276:immunology / Q000302:isolation & purification; D001404:Babesiosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D002981:Clindamycin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D004912:Erythrocytes / Q000469:parasitology; D005078:Exchange Transfusion, Whole Blood; D006801:Humans; D008297:Male; D011803:Quinine / Q000008:administration & dosage; D006435:Renal Dialysis; D013156:Splenectomy; D013548:Sweden; D014511:Uremia / Q000209:etiology / Q000628:therapy
D000913:Antibodies, Protozoan; D002981:Clindamycin; D011803:Quinine