Case Report: Overwhelming Babesia Parasitemia Successfully Treated Promptly With RBC Apheresis and Triple Therapy With Clindamycin, Azithromycin, and Atovaquone

Li, Yijia; Stanley, Susan E.; Villalba, Julian A.; Nelson, Sandra; Gelfand, Jeffrey A.

doi:10.1093/ofid/ofaa448

Cited by 6 publications

(4 citation statements)

References 11 publications

(13 reference statements)

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“…New therapeutics are urgently needed for patients with babesiosis. Exchange transfusion may potentially reduce mortality from babesiosis in immunocompromised patients with high levels of parasitemia [ 6 , 29–31 ]. Clofazimine, in conjunction with atovaquone, has been shown to successfully clear Babesia parasites in mice [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

Relapsing Babesiosis With Molecular Evidence of Resistance to Certain Antimicrobials Commonly Used to Treat Babesia microti Infections

Marcos

Wormser

2023

Open Forum Infectious Diseases

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Human babesiosis cases are emerging with an increased incidence and a wider geographic range worldwide. Relapsing babesiosis cases are becoming more frequently encountered in clinical practice associated with the use of immunosuppressive medications. The 2020 Infectious Diseases Society of America babesiosis guidelines recommends at least 6 weeks of antimicrobial treatment for highly immunocompromised patients with Babesia microti infection. Nevertheless, cases have relapsed even after 6 weeks of treatment. Genetic mutations regarded as the potential cause of antimicrobial resistance in B. microti have been identified in certain relapsing cases. A few alternative antimicrobial regimens have been used successfully to achieve cure for some of these cases, but other cases have had fatal outcomes. In this review, we discuss the molecular evidence of genetic resistance to certain antimicrobials commonly used to treat B. microti infections based on an evaluation of 9 patients with relapsing infection.

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Section: Resultsmentioning

confidence: 99%

Relapsing Babesiosis With Molecular Evidence of Resistance to Certain Antimicrobials Commonly Used to Treat Babesia microti Infections

Marcos

Wormser

2023

Open Forum Infectious Diseases

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“…Within 1 year after the fire, a total of 14 debris‐flow events of different sizes occurred in the Xiangjiao catchment (X. Li, 2021b). According to the debris‐flow incident report of the government (X. Li, 2021a) and the debris‐flow size scale established by Jakob (2005), class 4 and 7 debris‐flow events occurred on June 8 and 5 July 2021, respectively. At 14:00 on 5 July 2021, the government issued a rainstorm warning, and then issued a mountain torrent and debris‐flow warning.…”

Section: Study Areamentioning

confidence: 99%

Mechanistic Analysis and Numerical Simulation of the 2021 Post‐Fire Debris Flow in Xiangjiao Catchment, China

Ouyang

Xiang

et al. 2023

JGR Earth Surface

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With global warming, and drying of vegetation in many regions, forest fires and extreme rainfall have become issues of global concern (Jalaludin et al., 2020;Wei et al., 2020). Forest fires greatly change the water infiltration characteristics and root reinforcement of the soil on the hillside, which would facilitate the generation of debris flow (Wall et al., 2020). Post-fire debris flows triggered by rainfall are one of the most destructive and potentially deadly consequences in burned mountain landscapes (

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“…Similar mutations associated with azithromycin resistance have been reported in P. falciparum [ 20 ] and S. pneumoniae [ 45 ] RPL4. Alternative management strategies for human babesiosis in the case of persistent relapse include the use of different drug combinations such as atovaquone + azithromycin + clindamycin, atovaquone + clindamycin, atovaquone + proguanil, or atovaquone + azithromycin + clindamycin + quinine [ 26 , 41 , 46 , 47 ]. The introduction of other drugs such as doxycycline, moxifloxacin, pentamidine, trimethoprim-sulfamethoxazole or artemisinin to treatment regimens with the standard therapies was also reported [ 40 , 48 ].…”

Section: Current Treatments Against Human Babesiosismentioning

confidence: 99%

Treatment of Human Babesiosis: Then and Now

Renard

Mamoun

2021

Pathogens

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Babesiosis is an emerging tick-borne disease caused by apicomplexan parasites of the genus Babesia. With its increasing incidence worldwide and the risk of human-to-human transmission through blood transfusion, babesiosis is becoming a rising public health concern. The current arsenal for the treatment of human babesiosis is limited and consists of combinations of atovaquone and azithromycin or clindamycin and quinine. These combination therapies were not designed based on biological criteria unique to Babesia parasites, but were rather repurposed based on their well-established efficacy against other apicomplexan parasites. However, these compounds are associated with mild or severe adverse events and a rapid emergence of drug resistance, thus highlighting the need for new therapeutic strategies that are specifically tailored to Babesia parasites. Herein, we review ongoing babesiosis therapeutic and management strategies and their limitations, and further review current efforts to develop new, effective, and safer therapies for the treatment of this disease.

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Case Report: Overwhelming Babesia Parasitemia Successfully Treated Promptly With RBC Apheresis and Triple Therapy With Clindamycin, Azithromycin, and Atovaquone

Cited by 6 publications

References 11 publications

Relapsing Babesiosis With Molecular Evidence of Resistance to Certain Antimicrobials Commonly Used to Treat Babesia microti Infections

Relapsing Babesiosis With Molecular Evidence of Resistance to Certain Antimicrobials Commonly Used to Treat Babesia microti Infections

Mechanistic Analysis and Numerical Simulation of the 2021 Post‐Fire Debris Flow in Xiangjiao Catchment, China

Treatment of Human Babesiosis: Then and Now

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