Babesiosis

Babesiosis (pyroplasmosis) - the acute infectious disease characterised by an intoxication, a fever, development of an anaemia and serious progressing flow. The babesiosis concerns transmissible parasitogenic zoonotic infection contaminations. Disease has been diagnosed for the first time for the human in Yugoslavia in 1957.

Aetiology. The originator concerns a type of the elementary, class Sporozoa, family Babesiidae. Disease of the human is caused by three kinds Babesia: Babesia divergens, rodhaini - in Europe and Babesia microti in America. The babesiosis of animals causes also B. bovis and B. bigemina. Babesias settle down in the struck erythrocytes in the centre or on periphery of cells. At a coloration on Gram 2-3 microns or formations of the bulb-shaped form in diameter 4-5 microns look like thin rings in diameter.

Epidemiology. In the world literature by present time it is described all about 100 cases of a babesiosis, the majority from which has ended is lethal. Demonstrative forms of disease educed at persons with sharp disturbances of immune system, in particular after a splenectomy. The manifestation of a babesiosis at a HIV-infected Is considered probable. At humans with normally functioning immune system disease proceeds asymptomatically, despite presence of the parasitemia reaching of 1-2 %.

Disease meets in Europe (the Scandinavian countries, France, Germany, Yugoslavia, Poland) and in the USA (east coast). The master are mice-polevki and other gnawers, dogs, cats and large horned livestock. The babesiosis of animals is open in 1888 V.Babeshem. Annually only in Europe are registered ten thousand cases of disease of domestic animals. A transmitting agent - the eurysynusic pascual tick lxodes ricinus and argasid ticks. The originator remains in an organism of pincers for life and can be transferred transovarian. Tourists, agricultural workers, shepherds in activity of pincers (spring-and-summer and aestivo-autumnal seasons) are ill. The transmission of infection by hemotransfusions from the infected persons who have an asymptomatic parasitemia is possible.

The pathogenesis is studied insufficiently. After a puncture of the tick the originator inpours into vascular capillars and in erythrocytes. Reproduction Babesia descends in the erythrocytes which lysis is caused not only influence of parasites, but also appearance of antierythrocyte antibodies. Clinical implications arise, when the number of the struck erythrocytes reaches 3-5 %. At destruction of erythrocytes products of vital activity of parasites and heterogenous proteins that causes powerful pyrogenic reaction and other toxic implications get to blood. The accruing anaemia is accompanied by the expressed histic hypoxia and microcirculation disturbances. In renal capillars settle cellular covers ("shade") of erythrocytes and free haemoglobin that leads to development of a hematuria and acute renal insufficiency. At a massive lysis of erythrocytes disturbances of a pigmental exchange with accumulation in blood mainly an indirect bilirubin educe.

Symptoms and flow. The incubation interval proceeds from 3 days till 3 weeks (on the average 1-2 weeks). Illness begins always acutely with a fever and a fervescence to 38-40°С. The fever is accompanied by sharp delicacy, prostration, a headache, pains in epigastriums, a nausea and the vomiting which is not bringing simplification. A temperature curve of a constant or irregular type. The high fever proceeds usually 8-10 days with critical falling to normal or subnormal level in a disease end-stage. From 3-4th day of illness against intoxication increase there are profuse sweats, pallor of integuments and disturbance of a pigmental exchange. The liver is enlarged, the icterus accrues and from 6-7th day the hemoglobinuria educes. In the subsequent in a clinical picture of disease symptoms of acute renal insufficiency prevail. The lethal outcome is caused by an uremia or the joined intercurrent diseases (a pneumonia, sepsisomia, etc.).

Complications. The babesiosis naturally becomes complicated acute renal insufficiency, acute is renal-hepatic and multiorgan insufficiency. A joining nonspecific pneumonia worsens the forecast.

The diagnosis and the differential diagnosis. Clinical diagnostics is inconvenient. The long fever in a combination to an anaemia, a hepatomegalia in the absence of effect from treatment with application of anti-infectives is the establishment for laboratory researches on a babesiosis. The account of epidemiological data (punctures of pincers, stay in precinctive district) and revealing of disturbances of the immune status at the patient is especially important. The diagnosis proves to be true parasitologic originator detection in a smear and a thick drop of blood, and also in reaction of an indirect immunofluorescence. Diagnostic titer at unitary research not less 1:256. Apply also a reaction of binding complement.

At a low parasitemia sometimes use a biological method at which blood of the patient introduce to golden hamsters. After 2-4 weeks at animals disease educes and babesias are easily taped in a blood smear