학술논문
Persistent and Relapsing Babesiosis in Immunocompromised Patients
Document Type
research-article
Author
Krause, Peter J.; Gewurz, Benjamin E.; Hill, David; Marty, Francisco M.; Vannier, Edouard; Foppa, Ivo M.; Furman, Richard R.; Neuhaus, Ellen; Skowron, Gail; Gupta, Shaili; McCalla, Carlo; Pesanti, Edward L.; Young, Mary; Heiman, Donald; Hsue, Gunther; Gelfand, Jeffrey A.; Wormser, Gary P.; Dickason, John; Bia, Frank J.; Hartman, Barry; Telford, Sam R.; Christianson, Diane; Dardick, Kenneth; Coleman, Morton; Girotto, Jennifer E.; Spielman, Andrew
Source
Clinical Infectious Diseases, 2008 Feb 01. 46(3), 370-376.
Subject
Language
English
ISSN
10584838
Abstract
Background. Human babesiosis is a tickborne malaria-like illness that generally resolves without complication after administration of atovaquone and azithromycin or clindamycin and quinine. Although patients experiencing babesiosis that is unresponsive to standard antimicrobial therapy have been described, the pathogenesis, clinical course, and optimal treatment regimen of such cases remain uncertain. Methods. We compared the immunologic status, clinical course, and treatment of 14 case patients who experienced morbidity or death after persistence of Babesia microti infection, despite repeated courses of antibabesial treatment, with those of 46 control subjects whose infection resolved after a single course of standard therapy. This retrospective case-control study was performed in southern New England, New York, and Wisconsin. Results. All case patients were immunosuppressed at the time of acute babesiosis, compared with