Atovaquone plus cholestyramine in patients coinfected withBabesia microti andBorrelia burgdorferi refractory to other treatment

Shoemaker, Ritchie C.; Hudnell, H. Kenneth; House, Dennis E.; Kempen, Amy van; Pakes, Gary E.

doi:10.1007/bf02850341

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…This applies particularly for the chronic courses of the disease [80]. The use of the following antibiotics are recommended (Table 5 ): azithormycin [81,82], rifampicin, ciprofloxacin, trimethoprim combined with sulfamethoxazole, gentamycin [83,84], gentamycin i.v. [85], and doxycycline combined with gentamycin [86, 87].…”

Section: Bartonellosismentioning

confidence: 99%

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Chronic Lyme Disease and Co-infections: Differential Diagnosis

Berghoff¹

2012

TONEUJ

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In Lyme disease concurrent infections frequently occur. The clinical and pathological impact of co-infections was first recognized in the 1990th, i.e. approximately ten years after the discovery of Lyme disease. Their pathological synergism can exacerbate Lyme disease or induce similar disease manifestations. Co-infecting agents can be transmitted together with Borrelia burgdorferi by tick bite resulting in multiple infections but a fraction of co-infections occur independently of tick bite. Clinically relevant co-infections are caused by Bartonella species, Yersinia enterocolitica, Chlamydophila pneumoniae, Chlamydia trachomatis, and Mycoplasma pneumoniae. In contrast to the USA, human granulocytic anaplasmosis (HGA) and babesiosis are not of major importance in Europe. Infections caused by these pathogens in patients not infected by Borrelia burgdorferi can result in clinical symptoms similar to those occurring in Lyme disease. This applies particularly to infections caused by Bartonella henselae, Yersinia enterocolitica, and Mycoplasma pneumoniae. Chlamydia trachomatis primarily causes polyarthritis. Chlamydophila pneumoniae not only causes arthritis but also affects the nervous system and the heart, which renders the differential diagnosis difficult. The diagnosis is even more complex when co-infections occur in association with Lyme disease. Treatment recommendations are based on individual expert opinions. In antibiotic therapy, the use of third generation cephalosporins should only be considered in cases of Lyme disease. The same applies to carbapenems, which however are used occasionally in infections caused by Yersinia enterocolitica. For the remaining infections predominantly tetracyclines and macrolides are used. Quinolones are for alternative treatment, particularly gemifloxacin. For Bartonella henselae, Chlamydia trachomatis, and Chlamydophila pneumoniae the combination with rifampicin is recommended. Erythromycin is the drug of choice for Campylobacter jejuni.

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Section: Bartonellosismentioning

confidence: 99%

“…The transmission of the pathogen occurs primarily via ticks, namely Ixodes ricinus in Europe and Ixodes scapularis in the USA [29,30]. Babesia microti has been found as a co-infection in Lyme disease [253-255]. Other modes of transmission are blood transfusions [31] and perinatal infection [32,33].…”

Section: Babesiosismentioning

confidence: 99%

Chronic Lyme Disease and Co-infections: Differential Diagnosis

Berghoff¹

2012

TONEUJ

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“…A prospective randomized trial investigated the efficacy of a regimen of atovaquone and azithromycin compared to a regimen of clindamycin and quinine [14]. Another studied the efficacy of atovaquone and cholestyramine combination therapy [130]. Treatments were also investigated in 46/65 animal experiments and 29/65 in vitro anti-parasitic experiments.…”

Section: Resultsmentioning

confidence: 99%

“…There are several common treatments for babesiosis in humans. The majority of mild to moderate babesiosis cases are treatable with combination therapy of atovaquone and azithromycin [14, 130]. Recommendations for treatment of severe babesiosis include the use of clindamycin and quinine combination therapy [15, 144], which is not recommended for treatment of mild to moderate illness due to the risk of adverse reactions [14].…”

Section: Discussionmentioning

confidence: 99%

Zoonotic Babesia: A scoping review of the global evidence

et al. 2019

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BackgroundBabesiosis is a parasitic vector-borne disease of increasing public health importance. Since the first human case was reported in 1957, zoonotic species have been reported on nearly every continent. Zoonotic Babesia is vectored by Ixodes ticks and is commonly transmitted in North America by Ixodes scapularis, the tick species responsible for transmitting the pathogens that also cause Lyme disease, Powassan virus, and anaplasmosis in humans. Predicted climate change is expected to impact the spread of vectors, which is likely to affect the distribution of vector-borne diseases including human babesiosis.MethodsA scoping review has been executed to characterize the global evidence on zoonotic babesiosis. Articles were compiled through a comprehensive search of relevant bibliographic databases and targeted government websites. Two reviewers screened titles and abstracts for relevance and characterized full-text articles using a relevance screening and data characterization tool developed a priori.ResultsThis review included 1394 articles relevant to human babesiosis and/or zoonotic Babesia species. The main zoonotic species were B. microti, B. divergens, B. duncani and B. venatorum. Articles described a variety of study designs used to study babesiosis in humans and/or zoonotic Babesia species in vectors, animal hosts, and in vitro cell cultures. Topics of study included: pathogenesis (680 articles), epidemiology (480), parasite characterization (243), diagnostic test accuracy (98), mitigation (94), treatment (65), transmission (54), surveillance (29), economic analysis (7), and societal knowledge (1). No articles reported predictive models investigating the impact of climate change on Babesia species.ConclusionKnowledge gaps in the current evidence include research on the economic burden associated with babesiosis, societal knowledge studies, surveillance of Babesia species in vectors and animal hosts, and predictive models on the impact of climate change. The scoping review results describe the current knowledge and knowledge gaps on zoonotic Babesia which can be used to inform future policy and decision making.

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“…Rather than using traditional measures of visual testing, such as visual acuity, highcontrast stimuli testing of visual contrast sensitivity has presented better appraisals of visual dysfunction resulting from chemical exposures (Hitchcock, 2004). Chronic exposure to inhaled toxins, inflammagens and microbes routinely found in waterdamaged buildings (Berndston et al, 2016), in Lyme disease after tick bite (Shoemaker, Hudnell, House, van Kempen and Pakes, 2006), in Ciguatera (Shoemaker et al, 2010) and Pfiesteria toxin exposures (Shoemaker, 1998) and contact with cyanobacteria (Shoemaker et al, 2009) trigger immune dysregulation leading to multi-system and multi-symptom illness (Shoemaker and House, 2006) typically in genetically predisposed persons. One mechanism of injury seen in most CIRS patients is capillary hypoperfusion at multiple sites.…”

Section: Introductionmentioning

confidence: 99%

Pediatrics Norms for Visual Contrast Sensitivity Using an APT VCS Tester

McMahon¹,

Kundomal

Yangalasetty

2017

MRAJ

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This graph plots spatial frequency measured in CPD (cycles per degree of visual arc) against the average number of correct responses before an error (raw score) in each frequency. "І" designates 1 and 2 standard deviations at each CPD. Diagram 3 Key: This graph plots spatial frequency measured in CPD (cycles per degree of visual arc) for boys and girls against the log of the contrast sensitivity at each frequency. "І" designates 1 and 2 standard deviations at each CPD.

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Atovaquone plus cholestyramine in patients coinfected withBabesia microti andBorrelia burgdorferi refractory to other treatment

Cited by 7 publications

References 16 publications

Chronic Lyme Disease and Co-infections: Differential Diagnosis

Chronic Lyme Disease and Co-infections: Differential Diagnosis

Zoonotic Babesia: A scoping review of the global evidence

Pediatrics Norms for Visual Contrast Sensitivity Using an APT VCS Tester

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