Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Department of Urology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Folia Parasitol (Praha). 2020 Oct 30;67:2020.031. doi: 10.14411/fp.2020.031.
Babesiosis is a tick-borne disease that may exhibit a broad range of clinical manifestations. According to the Food and Drug Administration (FDA), Babesia species belong to the most common transfusion-transmitted pathogens (FDA, May 2019), but the awareness of the disease caused by these parasitic protists is still low. In immunocompromised patients, the clinical course of babesiosis may be of extreme severity and may require hospital admission. We demonstrate a case of a young male who experienced severe polytrauma requiring repetitive blood transfusions. Six months later, the patient developed a classic triad of arthritis, conjunctivitis and non-specific urethritis. These symptoms largely mimicked Reiter's syndrome. The patient was later extensively examined by an immunologist, rheumatologist, urologist, and ophthalmologist with no additional medical findings. In the search for the cause of his symptoms, a wide laboratory testing for multiple human pathogens was performed and revealed a babesiosis infection. This was the first case of human babesiosis mimicking Reiter's syndrome. Following proper antimicrobial therapy, the patient fully recovered in four weeks. We aim to highlight that a search for Babesia species should be considered in patients with non-specific symptomatology and a history of blood transfusion or a possible tick exposure in pertinent endemic areas.
巴贝虫病是一种蜱传疾病,可能表现出广泛的临床表现。根据美国食品和药物管理局(FDA)的说法,巴贝虫属属于最常见的输血传播病原体(FDA,2019 年 5 月),但人们对这些寄生虫引起的疾病的认识仍然很低。在免疫功能低下的患者中,巴贝虫病的临床病程可能非常严重,可能需要住院治疗。我们展示了一例年轻男性患者,他经历了严重的多发伤,需要反复输血。六个月后,患者出现了关节炎、结膜炎和非特异性尿道炎的典型三联征。这些症状在很大程度上类似于赖特综合征。随后,患者由免疫学家、风湿病学家、泌尿科医生和眼科医生进行了广泛检查,但未发现其他医学发现。在寻找他症状的原因时,对多种人类病原体进行了广泛的实验室检测,结果显示感染了巴贝虫。这是首例人类巴贝虫病模仿赖特综合征的病例。经过适当的抗菌治疗,患者在四周内完全康复。我们旨在强调,对于有非特异性症状且有输血史或在相关流行地区可能有蜱虫暴露史的患者,应考虑寻找巴贝虫属。