a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
b Department of Microbiology, Faculty of Biology and Chemistry , University of Białystok , Bialystok , Poland ;
Infect Dis (Lond). 2016 Jul;48(7):537-43. doi: 10.3109/23744235.2016.1164339. Epub 2016 Apr 27.
The aim of the study was to evaluate the clinical course and effectiveness of diagnostics tools for Babesia spp. infection in patients bitten by ticks.
Five hundred and forty-eight patients hospitalised or seen in outpatients department because of various symptoms after a tick bite were included in the study. PCR, nucleotide sequencing of Babesia 18S rRNA gene fragment, blood smears and serological tests for Babesia spp., TBEV, A. phagocytophilum and B. burgdorferi were performed in all patients. Six patients infected with Babesia were included in the final analysis. They had PCR, Babesia 18S rRNA gene fragment nucleotide sequencing, blood smears and serological tests for Babesia spp., TBEV, A. phagocytophilum and B. burgdorferi performed twice.
Tick-borne infection with Babesia microti in six immunocompetent patients with non-specific symptoms was confirmed for the first time in Poland. No severe course of the disease was seen. No piroplasm forms were noticed within erythrocytes on blood smear. Three patients developed a serological response.
Immunocompetent patients may be unaware of infection with Babesia microti after a tick bite. It must be included in the differential diagnosis after the tick bite. In patients with low parasitaemia PCR and serology seem useful when blood smear is negative. Self-elimination of Babesia spp. is possible, especially in cases with low parasitaemia.
本研究旨在评估蜱叮咬后出现各种症状的患者巴贝虫属感染的临床过程和诊断工具的有效性。
本研究共纳入 548 例因蜱叮咬后出现各种症状而住院或门诊就诊的患者。对所有患者均进行了 PCR、巴贝虫 18S rRNA 基因片段核苷酸测序、血涂片和巴贝虫属、TBEV、嗜吞噬细胞无形体和伯氏疏螺旋体的血清学检测。最终分析中纳入了 6 例感染巴贝虫的患者。对他们进行了两次 PCR、巴贝虫 18S rRNA 基因片段核苷酸测序、血涂片和巴贝虫属、TBEV、嗜吞噬细胞无形体和伯氏疏螺旋体的血清学检测。
首次在波兰证实了 6 例免疫功能正常的非特异性症状患者的蜱传感染巴贝虫微孢子虫。未观察到严重的疾病过程。血涂片上未发现红细胞内的梨浆体。3 例患者出现血清学反应。
免疫功能正常的患者在蜱叮咬后可能没有感染巴贝虫微孢子虫的意识。在蜱叮咬后,应将其纳入鉴别诊断。在血涂片阴性时,低寄生虫血症患者的 PCR 和血清学似乎有用。巴贝虫属的自我消除是可能的,特别是在低寄生虫血症的情况下。