Babesiosis in splenectomized adults

Rosner, Fred; Zarrabi, Mahboobeh; Benach, Jorge L.; Habicht, Gail S.

doi:10.1016/0002-9343(84)90298-5

Cited by 183 publications

(86 citation statements)

References 41 publications

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“…Some authors also recommend annual vaccination against influenza virus, because influenza predisposes to sepsis and pneumonia (11,12). Splenectomized patients are also more prone to develop infections caused by Babesia, capnocytophaga or anaplasma phagocytopilum (13)(14)(15)(16)(17). The problem is that for these kinds of infections there is no immunization available (6).…”

Section: Infectious Risksmentioning

confidence: 99%

Patients After Splenectomy: Old Risks and New Perspectives

Dragomir¹,

Petrescu²,

Manga³

et al. 2016

chr

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Rezumat Pacienåii post-splenectomie: complicaåii cunoscute aei perspective noiComplicaåiile care survin în urma splenectomiei pot fi împãråite în infecåioase aei non-infecåioase. Legãtura dintre splenectomie aei aceste riscuri este doar paråial înåeleasã. Rãspunsul imun al gazdei împotriva infecåiei este profund modificat post-splenectomie, iar aceaeti indivizi sunt mai susceptibili sã dezvolte sepsis aei infecåia are o evoluåie fulminantã. Splenectomia este de asemenea un potenåial factor de risc pentru numeroase complicaåii vasculare care rezultã în urma obstrucåiei paråiale sau totale ale unei artere sau vene. În plus, hipertensiunea pulmonarã poate fi o complicaåie severã aei uneori fatalã a splenectomiei. Unii autori includ aei neoplaziile, diabetul zaharat aei pancreatita acutã în categoria complicaåiilor non-infecåioase post-splenectomie. Cea mai de temut complicaåie pentru pacienåii splenectomizaåi rãmâne sepsisul. Fiziopatologia sepsisului încã este controversatã. Decesul în sepsis poate surveni fie în urma hiperinflamaåiei, fie în urma imunosupresiei. Multiple dovezi experimentale au dovedit implicarea microRNA-urilor celulare aei virale în sepsis. Considerãm faptul cã microRNA-urile sunt de asemenea asociate cu imunosupresia pacientului asplenic, ceea ce determinã o creaetere a riscului de sepsis fatal. Studierea nivelului expresiei plasmatice a microRNA-urilor circulante la pacienåii asplenici, ar putea conduce la o mai bunã înåelegere a imunosupresiei post-splenectomie aei la dezvoltarea unor noi metode diagnostice aei terapeutice.Cuvinte cheie: splenectomie, microRNA, sepsis, microRNA-uri virale, OPSI AbstractThe risks that arise after splenectomy can be divided in infectious and non-infectious. The link between splenectomy and these hazards remains partially unknown. Host defense against infection is altered after splenectomy and such individuals develop sepsis more easily and the infection has a fulminant course. Splenectomy is also a potential risk factor for several vascular complications that result from partial or total obstruction of an arterial or venous blood vessel. Furthermore, pulmonary hypertensioncan be a severe and sometimes fatal complication following splenectomy. Some authors also consider that malignancies, diabetes mellitus and acute pancreatitis are non-infectious complications after splenectomy. The most feared complication for splenectomized patients remains sepsis. The pathophysiology of sepsis is still controversial. Death in sepsis can occur due to either hyper-inflammation or "immune paralysis". Multiple experimental evidences link cellular and viral microRNAs with sepsis. We presume that General ReportChirurgia (2016)

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Section: Infectious Risksmentioning

confidence: 99%

Patients After Splenectomy: Old Risks and New Perspectives

Dragomir¹,

Petrescu²,

Manga³

et al. 2016

chr

View full text Add to dashboard Cite

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“…Older, immunocompromised, and asplenic patients experience similar symptoms but with increased severity. Even in immunocompetent patients, babesiosis can persist for many months [3][4][5][6][7][8]. It can quickly become life threatening and cause death if proper clinical treatment is not administered on time.…”

Section: Introductionmentioning

confidence: 99%

Inhibitory effects of 19 antiprotozoal drugs and antibiotics on Babesia microti infection in BALB/c mice

Yao

Zhang

Liu

et al. 2015

J Infect Dev Ctries

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Introduction: Different results have been achieved in the evaluation of antiparasitic drug activity in Mongolian jirds, hamsters, and BALB/c mice infected with Babesia microti. The aims of the present study were to find a preferable method for drug screening and to re-evaluate the activity of several drugs against B. microti. Methodology: The activity of 19 drugs on B. microti-infected BALB/c mice was evaluated. The study was built on Peters' four-day suppressive test, and the pathogenicity of the blood from the treated mice was also used as indicator. Results: The results showed that 15 of the 19 drugs had little or no in vivo effect against B. microti. The inhibitory rates of atovaquone and azithromycin were high at all doses, but the microscopy-negative blood of recovered mice was still infectious. Similar to robenidine hydrochloride at 25 and 50 mg/kg, primaquine at 100 mg/kg had a 100% inhibitory rate. Robenidine hydrochloride achieved a 100% inhibitory rate at 100 mg/kg, and the blood of recovered mice did not result in parasitemia in subpassage experiments. Parasite-negative blood from mice treated with antimalarial drugs (clinically used for babesiosis) still caused parasitemia in subpassage experiments. This suggests that these drugs cannot eradicate the parasites. Conclusions: Peters' four-day suppressive test and the pathogenicity of the blood from the treated mice are suitable methods for preliminary investigating possible drugs against B. microti. Considering that robenidine hydrochloride achieved the best activity against B. microti in BALB/c mice in our study, further studies are needed.

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“…Severe symptoms resulting from high parasitemia and the ensuing circulatory complications are more commonly encountered among the splenectomized, the immunocompromised, and the elderly (15,48,56). Asymptomatic infections have been well documented, and seroprevalence estimates in regions of endemicity have ranged from 0 to 10%, depending on the year, location, and season of blood collection (10, 20, 24, 26-28, 33, 49).…”

mentioning

confidence: 99%

Multiplex Assay Detection of Immunoglobulin G Antibodies That Recognize Babesia microti Antigens

Priest

Moss

Won

et al. 2012

Clin Vaccine Immunol

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Human babesiosis, a blood-borne infection caused by several species of Babesia, including B. microti, is an emerging disease that is endemic in the Northeast, upper Midwest, and Pacific Northwest regions of the United States. Risk factors for babesiosis include exposure to the infected tick vector and blood transfusions from infected donors. In this work, we cloned and expressed two of the immunodominant antigens from B. microti and used them in a multiplex bead format assay (MBA) to detect parasitespecific IgG responses in human sera. The MBA using recombinant B. microti secreted antigen 1 (BmSA1) protein was more specific (100%) and slightly more sensitive (98.7%) than the assay using a truncated recombinant BMN1-17 construct (97.6% and 97.4%, respectively). Although some antibody reactivity was observed among sera from confirmed-malaria patients, only one Plasmodium falciparum sample was simultaneously positive for IgG antibodies to both antigens. Neither antigen reacted with sera from babesiosis patients who were infected with Babesia species other than B. microti. Both positive and negative MBA results were reproducible between assays and between instruments. Additional studies of these recombinant antigens and of the multiplex bead assay using blood samples from clinically defined babesiosis patients and from blood donors are needed to more clearly define their usefulness as a blood screening assay.

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Babesiosis in splenectomized adults

Cited by 183 publications

References 41 publications

Patients After Splenectomy: Old Risks and New Perspectives

Patients After Splenectomy: Old Risks and New Perspectives

Inhibitory effects of 19 antiprotozoal drugs and antibiotics on Babesia microti infection in BALB/c mice

Multiplex Assay Detection of Immunoglobulin G Antibodies That Recognize Babesia microti Antigens

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