Professional Documents
Culture Documents
Case 16
Case 16
Case 16
Reporter: I2
Date: 94/11/28
Physical examination
headache,fatigue,fever,shaking chills
joint and muscle aches, and other vague
flu-like symptoms
Laboratory tests
Fig.16.1
Babesiosis ()
ETIOLOGY
EPIDEMIOLOGY
Ticks is prevalent:
Nantucket Island of Massachusetts
Block Island in Rhode Island
Long Island,Shelter Island, Fire Island in New
York
focal areas in Connecticut, Wisconsin, Minnesota
Between May~August
In Nantucket 60% of deer mice are infected
with B.
microti.
CLINICAL PRESENTATION
DIAGNOSIS
Laboratory Findings
Giemsa-stain
TREATMENT
Intact spleenself-limiting although symptoms may
persist for months .
Clindamycin(1.2 g Bid IV or 600 mg Tid po for 7~10 days)
Quinine(650mgTid po for 7 days)
Atovaquone(750mg po Bid for 7~10 days)
Azithromycin(600 mg po Qd for 7~10 days)
Severe infections (parasitemia/asplenic)in addition to
exchange transfusions
Occasionally, pulmonary edema may develop after
initiation of therapy.
Question 1
Answer 1
DxBabesiosis
Protozoan B. microti & B. divergens are
the two that cause most human infections
Question 2
Answer 2
Ringlike&crucifix-shaped structuresmerozoite
Hints:
1.She had recently spent the summer working
as a waitress in Nantucket,Mass.
2.She had had a splenectomy due to injuries
suffered in a ski accident.
Question 3
Answer 3
Ticks is prevalent:
Nantucket Island of Massachusetts
Block Island in Rhode Island
Long Island,Shelter Island, Fire Island in New York
focal areas in Connecticut, Wisconsin, Minnesota
Between May~August
In Nantucket 60% of deer mice are infected with B.
microti.
Question 4
Answer 4
VectorTicks ()
The tick of may simultaneously transmit
1.Borrelia burgdorferitheLyme disease
2.Ehrlichia (Anaplasma) speciesehrlichiosis
(Rickettsia, Ehrlichia)
=>Those coinfections may make clinical illness
more severe and warrant special therapy.
Question 5
Answer 5
Question 6
Answer 6
Blood transfusion
Acquired perinatally
Question 7
Answer 7
Geographical
region
Protozoan
Vector
Northeastern
United States
California
Washington
Babesia microti
Babesia gibsoni
Ixodes tick
(transmits Lyme
disease)
unidentified
Europe
Babesia
divergens
Ixodes tick
Question 8
Answer 8
References