LETTER
Babesiosis in Missouri
Ryland P. Byrd Jr., MD, and
Thomas M. Roy, MD
15 January 1997 | Volume 126 Issue 2 | Page 172
TO THE EDITOR:
We read with interest the report by Herwaldt and colleagues [1] of a patient infected with a Babesia species not previously recognized to infect humans. This intraerythrocytic piroplasm was distinct from but shared morphologic, antigenic, and molecular characteristics with Babesia divergens. Human cases of babesiosis are caused by B. divergens in Europe and B. microti in the United States. Herwaldt and colleagues' patient was recognized to have babesiosis when ring forms were identified on a blood smear. After appropriate antibiotic therapy was initiated, the patient had cardiopulmonary arrest that was attributed to hypoxemia. Diffuse pulmonary infiltrates were noted on a chest radiograph and were thought to be due, at least in part, to volume overload. The patient never regained baseline mental status. Life support was subsequently discontinued, and the patient died. Unfortunately, no autopsy was done.
We suspect that an autopsy would have shown diffuse alveolar damage. Six patients with adult respiratory distress syndrome associated with babesiosis have been described in the literature [2-5]. Importantly, each of these patients had been receiving effective therapy for babesiosis for several days before developing the adult respiratory distress syndrome. This leaky capillary syndrome in babesiosis is unique in that it occurs only after the initiation of therapy with various antimicrobial agents.
|
Author and Article Information
|
|---|
James H. Quillen College of Medicine, Johnson City, TN 37614
1. Herwaldt BL, Persing DH, Precigout EA, Goff WL, Mathiesen DA, Taylor PW, et al. A fatal case of babesiosis in Missouri: identification of another piroplasm that infects humans. Ann Intern Med. 1996; 124:643-50.
2. Horowitz ML, Coletta F, Fein AM. Delayed onset adult respiratory distress syndrome in babesiosis. Chest. 1994; 106:1299-301.
3. Gordon S, Cordon RA, Mazdzer EJ, Valigorsky JM, Blagg NA, Barnes SJ, et al. Adult respiratory distress syndrome in babesiosis. Chest. 1984; 86:633-4.
4. Boustani MR, Lepore TJ, Gelfand JA, Lararus DS. Acute respiratory failure in patients treated for babesiosis. Am J Respir Crit Care Med. 1994; 149:1689-91.
5. Iacopino V, Earnhart T. Life-threatening babesiosis in a woman from Wisconsin. Arch Intern Med. 1990; 150:1527-8.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Top
Author & Article Info
References
Article
