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Weingart C, Krücken J, Kohn B. Repeated imidocarb treatment failure suggesting emerging resistance of Babesia canis in a new endemic area in north-eastern Germany. Ticks Tick Borne Dis 2024; 15:102315. [PMID: 38301344 DOI: 10.1016/j.ttbdis.2024.102315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
Canine babesiosis has been increasingly diagnosed in various regions of Germany such as north-eastern Germany in recent years. A dog with several relapses of Babesia canis infection after treatment with imidocarb is described. A 9-year-old male Magyar Viszla with B. canis infection was referred after two treatments with imidocarb (dosage 2.1 mg/kg SC) because of lethargy, fever and pancytopenia (additional treatments with prednisolone and doxycycline). Merozoites were detected in the blood smear and imidocarb treatment was repeated. Clinical signs, pancytopenia and a positive B. canis PCR occurred after the 3rd (6 mg/kg SC), 4th (7.7 mg/kg SC) and 5th (7.5 mg/kg SC and doxycycline for 4 weeks in addition) imidocarb injection and thorough tick prevention with isoxazoline and permethrin products. 12 days after the 5th injection, the PCR was negative for the first time. The dog was again presented with fever 35 days after the 5th injection. The B. canis PCR was positive and laboratory examination revealed pancytopenia. Treatment with atovaquone/azithromycin for 18 days was performed and no further relapse occurred for 32 weeks. In the case of suspected imidocarb resistance in B. canis infection, treatment with atovaquone/azithromycin can be an alternative.
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Affiliation(s)
- Christiane Weingart
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Oertzenweg 19 b 14163, Germany.
| | - Jürgen Krücken
- Institute for Parasitology and Tropical Veterinary Medicine, School of Veterinary Medicine, Freie Universität Berlin, Germany
| | - Barbara Kohn
- Small Animal Clinic, School of Veterinary Medicine, Freie Universität Berlin, Oertzenweg 19 b 14163, Germany
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2
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Huang L, Sun Y, Huo DD, Xu M, Xia LY, Yang N, Hong W, Huang L, Nie WM, Liao RH, Zhang MZ, Zhu DY, Li Y, Ma HC, Zhang X, Li YG, Huang XA, Wang JY, Cao WC, Wang FS, Jiang JF. Successful treatment with doxycycline monotherapy for human infection with Babesia venatorum (Babesiidae, Sporozoa) in China: a case report and proposal for a clinical regimen. Infect Dis Poverty 2023; 12:67. [PMID: 37443058 PMCID: PMC10339522 DOI: 10.1186/s40249-023-01111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/31/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Human babesiosis is a worldwide disease caused by intraerythrocytic protozoa of the genus Babesia. It is transmitted by bites from ixodid ticks, and mechanically transmitted by blood transfusion. It is primarily treated with quinine and/or atovaquone, which are not readily available in China. In this study, we developed a novel treatment regimen involving doxycycline monotherapy in a patient with severe Babesia venatorum infection as an alternative therapeutic medication. The aim of our study is to provide a guidance for clinical practice treatment of human babesiosis. CASE PRESENTATION A 73-year-old man who had undergone splenectomy and blood transfusion 8 years prior, presented with an unexplained fever, headache, and thrombocytopenia, and was admitted to the Fifth Medical Center of the PLA General Hospital. He was diagnosed with B. venatorum infection by morphological review of thin peripheral blood smears, which was confirmed by multi-gene polymerase chain reaction (PCR), and sequencing of the entire 18s rRNA and partial β-tubulin encoding genes, as well as isolation by animal inoculation. The doxycycline monotherapy regimen (peros, 0.1 g bisindie) was administered following pharmacological guidance and an effective outcome was observed. The patient recovered rapidly following the doxycycline monotherapy. The protozoan load in peripheral blood samples decreased by 88% in hematocrit counts after 8 days, and negative PCR results were obtained after 90 days of follow-up at the hospital. The treatment lasted for 3 months without any side effects or sequelae. The nine-month follow-up survey of the patient did not reveal any signs of recrudescence or anti-babesial tolerance. CONCLUSIONS We have reported a clinical case of successful doxycycline monotherapy for human babesiosis caused by B. venatorum, which provides an optional medical intervention for human babesiosis.
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Affiliation(s)
- Lei Huang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Yi Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China
| | - Dan-Dan Huo
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Ming Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China
- Inner Mongolia Medical University, Hohhot, 010059, People's Republic of China
| | - Luo-Yuan Xia
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China
- School of Public Health, Shandong University, Jinan, 250100, People's Republic of China
| | - Ning Yang
- The Center for Clinical Laboratory, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Wei Hong
- The Center for Clinical Laboratory, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Lin Huang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China
| | - Wei-Min Nie
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Ru-He Liao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510000, People's Republic of China
| | - Ming-Zhu Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China
| | - Dai-Yun Zhu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China
| | - Yan Li
- The Center for Clinical Laboratory, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - He-Cheng Ma
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Xin Zhang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Yong-Gang Li
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China
| | - Xin-An Huang
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510000, People's Republic of China
| | - Jing-Yuan Wang
- School of Public Health, Shandong University, Jinan, 250100, People's Republic of China
| | - Wu-Chun Cao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China.
- School of Public Health, Shandong University, Jinan, 250100, People's Republic of China.
| | - Fu-Sheng Wang
- Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, People's Republic of China.
| | - Jia-Fu Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, People's Republic of China.
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3
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Karasová M, Tóthová C, Grelová S, Fialkovičová M. The Etiology, Incidence, Pathogenesis, Diagnostics, and Treatment of Canine Babesiosis Caused by Babesia gibsoni Infection. Animals (Basel) 2022; 12:ani12060739. [PMID: 35327136 PMCID: PMC8944684 DOI: 10.3390/ani12060739] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Babesia gibsoni is a parasite that causes the rupture of red blood cells in dogs. Although there is no natural, tick-borne transmission of this disease in Europe, it has become more common in European countries in recent years. Dogfighting breeds are predisposed to disease and they are a potential source of infection. Given the high popularity of these dog breeds in Europe and the participation of many dogs at sports competitions and shows, it is likely that the incidence of the disease in Europe may be higher than expected. The fact that the disease is mostly manifested as asymptomatic infection and that dogs of predisposed breeds are often imported from endemic areas, or they travel due to mating or competitions around the world, also contributes to this hypothesis. Abstract Babesia gibsoni is one of the small Babesia species and the infection this pathogen causes is usually asymptomatic, which complicates the capture of potential parasite carriers. In endemic areas, especially in Asia, B. gibsoni occurs quite often due to direct transmission by way of a tick vector. Due to the absence of vectors, its occurrence is described only sporadically in Europe; but, it is increasingly occurring in predisposed, so-called fighting breeds, especially the American pit bull terrier. This review describes the etiology, incidence, clinical signs, pathogenesis, diagnostics, and treatment of B. gibsoni infection, with an emphasis on the clinical and laboratory peculiarities of the disease. As the treated dogs do not eliminate the parasite from the body—only reducing parasitemia and improving clinical signs—the treatment of B. gibsoni infection is a challenge in many cases, and its study therefore deserves great attention.
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Affiliation(s)
- Martina Karasová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia; (S.G.); (M.F.)
- Correspondence:
| | - Csilla Tóthová
- Clinic of Ruminants, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia;
| | - Simona Grelová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia; (S.G.); (M.F.)
| | - Mária Fialkovičová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia; (S.G.); (M.F.)
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Paulino PG, Pires MS, da Silva CB, Peckle M, da Costa RL, Vitari GLV, de Abreu APM, Massard CL, Santos HA. Molecular epidemiology of Babesia vogeli in dogs from the southeastern region of Rio de Janeiro, Brazil. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2018; 13:160-165. [PMID: 31014866 DOI: 10.1016/j.vprsr.2018.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 06/16/2018] [Accepted: 06/17/2018] [Indexed: 11/19/2022]
Abstract
Hemoparasitic diseases are prominent in domestic animals, particularly in Brazil, a tropical country with a wide range of vectors. This study investigated the epidemiology of Babesia vogeli in the whole blood of dogs from the southeastern region of Rio de Janeiro, Brazil. Whole blood samples from 390 dogs were screened for the presence of B. vogeli DNA by qPCR using the heat shock protein 70 kDa (hsp70) gene of B. vogeli. Characteristics related to the host and its environment were collected using a questionnaire. Bivariate analysis was used to evaluate each factor individually. A phi correlation test was used to verify collinearity. The variables with p < .1 and a low or moderate correlation with the other variables were selected for the multivariate analysis. Multiple models were created, and the best logistic regression model was chosen using the Akaike Information Criterion (AIC). The final model was used to determine which variables were closely related to B. vogeli infections in dogs. Of the 390 dog blood samples, 15.66% were positive for B. vogeli. The variables cat contact, age, shelter, street or woods access, tick infestation and fur lengthwere included in the final model. Per the logistic regression analysis, three variables explained B. vogeli detection in dogs: age (odds ratio [OR] = 2.12; p-value <.05; confidence interval [CI]: 1.13-3.96), tick infestation (OR = 2.08; p-value <.05; CI: 1.10-3.93) and shelter (OR = 2.22; p-value <.05; CI: 1.16-4.26). These variables were determined to be associated with B. vogeli detection in domiciled dogs in the southeastern region of Rio de Janeiro, Brazil. These data indicate that the age of the animal, the presence of ticks and the lack of shelter directly affect the epidemiology of B. vogeli.
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Affiliation(s)
- Patrícia G Paulino
- Department of Epidemiology and Public Health, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Marcus S Pires
- Department of Animal Parasitology, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Claudia B da Silva
- Department of Epidemiology and Public Health, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Maristela Peckle
- Department of Animal Parasitology, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Renata L da Costa
- Department of Animal Parasitology, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Gabriela L V Vitari
- Department of Epidemiology and Public Health, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Ana Paula M de Abreu
- Department of Animal Parasitology, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Carlos L Massard
- Department of Animal Parasitology, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil
| | - Huarrisson A Santos
- Department of Epidemiology and Public Health, Veterinary Institute, Federal Rural University of Rio de Janeiro, Br 465, km 7, Seropedica, Rio de Janeiro 23897-000, Brazil.
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5
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Mareedu N, Schotthoefer AM, Tompkins J, Hall MC, Fritsche TR, Frost HM. Risk Factors for Severe Infection, Hospitalization, and Prolonged Antimicrobial Therapy in Patients with Babesiosis. Am J Trop Med Hyg 2017; 97:1218-1225. [PMID: 28722598 DOI: 10.4269/ajtmh.17-0146] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Babesiosis is an emerging tick-borne disease transmitted by the hard tick Ixodes scapularis, which also transmits Lyme disease. Better gradation of prognostic indicators are needed to determine which patients may develop serious complications requiring hospitalization, and to provide early guidance on appropriate therapy. In this study, we evaluated 128 patients with smear or real time polymerase chain reaction-confirmed Babesia microti infections over a period of 16 years. Patients with asplenia or immunocompromising conditions were more likely to have severe infection (P < 0.01), require hospitalization (P < 0.01), or receive prolonged courses of antimicrobials (P < 0.01). Nausea or vomiting (P < 0.01) and diarrhea (P < 0.01) along with hyperbilirubinemia (P < 0.01) were predictive of severe infection, hospitalization, and prolonged antimicrobial therapy. Patients with concurrent Lyme disease were less likely to require hospitalization and had similar severity of disease and length of antibiotic treatment compared with those without Lyme disease.
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Affiliation(s)
| | | | | | | | - Thomas R Fritsche
- University of Wisconsin, La Crosse, Wisconsin.,Marshfield Clinic Health System, Marshfield, Wisconsin
| | - Holly M Frost
- Marshfield Clinic Health System, Minocqua, Wisconsin.,Marshfield Clinic Research Institute, Marshfield, Wisconsin
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6
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Solano-Gallego L, Sainz Á, Roura X, Estrada-Peña A, Miró G. A review of canine babesiosis: the European perspective. Parasit Vectors 2016; 9:336. [PMID: 27289223 PMCID: PMC4902949 DOI: 10.1186/s13071-016-1596-0] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/17/2016] [Indexed: 12/03/2022] Open
Abstract
Canine babesiosis is a significant tick-borne disease caused by various species of the protozoan genus Babesia. Although it occurs worldwide, data relating to European infections have now been collected for many years. These data have boosted the publication record and increased our working knowledge of these protozoan parasites. Both the large and small forms of Babesia species (B. canis, B. vogeli, B. gibsoni, and B. microti-like isolates also referred to as "B. vulpes" and "Theileria annae") infect dogs in Europe, and their geographical distribution, transmission, clinical signs, treatment, and prognosis vary widely for each species. The goal of this review is to provide veterinary practitioners with practical guidelines for the diagnosis, treatment and prevention of babesiosis in European dogs. Our hope is that these guidelines will answer the most frequently asked questions posed by veterinary practitioners.
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Affiliation(s)
- Laia Solano-Gallego
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Ángel Sainz
- Department of Animal Medicine and Surgery, Veterinary Clinic Hospital, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Xavier Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Agustín Estrada-Peña
- Department of Animal Pathology, Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
| | - Guadalupe Miró
- Department of Animal Health, Veterinary Clinic Hospital, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain
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7
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Iguchi A, Shiranaga N, Matsuu A, Hikasa Y. Efficacy of Malarone(®) in dogs naturally infected with Babesia gibsoni. J Vet Med Sci 2014; 76:1291-5. [PMID: 24909969 PMCID: PMC4197161 DOI: 10.1292/jvms.14-0139] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The efficacy of
Malarone® alone and in combination with doxycycline (DOXY) against
Babesia gibsoni infections was examined in 8 dogs. In all dogs except
one treated with Malarone®, parasitemia decreased, and anemia improved soon
after initiation of treatment. However, 3 of 4 dogs treated with Malarone®
relapsed, and relapse was inhibited in 2 of 4 dogs treated with Malarone® and
DOXY. All relapsed dogs responded well to the second treatment, but 1 dog relapsed again
and did not respond to the third treatment. Malarone® may be useful for acute
stage of B. gibsoni infections, and at least second repeating treatment
might be effective.
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Affiliation(s)
- Aiko Iguchi
- Laboratory of Veterinary Internal Medicine, Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori 680-8553, Japan
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8
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Abstract
Canine babesiosis caused by different Babesia species is a protozoal tick-borne disease with worldwide distribution and global significance. Historically, Babesia infection in dogs was identified based on the morphologic appearance of the parasite in the erythrocyte. All large forms of Babesia were designated Babesia canis, whereas all small forms of Babesia were considered to be Babesia gibsoni. However, the development of molecular methods has demonstrated that other Babesia species such as Babesia conradae, Babesia microti like piroplasm, Theileria spp. and a yet unnamed large form Babesia spp. infect dogs and cause distinct diseases. Babesia rossi, B. canis and Babesia vogeli previously considered as subspecies are identical morphologically but differ in the severity of clinical manifestations which they induce, their tick vectors, genetic characteristics, and geographic distributions, and are therefore currently considered separate species. The geographic distribution of the causative agent and thus the occurrence of babesiosis are largely dependent on the habitat of relevant tick vector species, with the exception of B. gibsoni where evidence for dog to dog transmission indicates that infection can be transmitted among fighting dog breeds independently of the limitations of vector tick infestation. Knowledge of the prevalence and clinicopathological aspects of Babesia species infecting dogs around the world is of epidemiologic and medical interest. Babesiosis in domestic cats is less common and has mostly been reported from South Africa where infection is mainly due to Babesia felis, a small Babesia that causes anemia and icterus. In addition, Babesia cati was reported from India and sporadic cases of B. canis infection in domestic cats have been reported in Europe, B. canis presentii in Israel and B. vogeli in Thailand. Babesiosis caused by large Babesia spp. is commonly treated with imidocarb dipropionate with good clinical response while small Babesia spp. are more resistant to anti-babesial therapy. Clinical and parasitological cure are often not achieved in the treatment of small Babesia species infections and clinical relapses are frequent. The spectrum of Babesia pathogens that infect dogs and cats is gradually being elucidated with the aid of molecular techniques and meticulous clinical investigation. Accurate detection and species recognition are important for the selection of the correct therapy and prediction of the course of disease.
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Ayoob AL, Hackner SG, Prittie J. Clinical management of canine babesiosis. J Vet Emerg Crit Care (San Antonio) 2010; 20:77-89. [PMID: 20230437 DOI: 10.1111/j.1476-4431.2009.00489.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To review and summarize current information regarding epidemiology, pathogenesis, and pathophysiology leading to the various clinical syndromes associated with canine babesiosis. Diagnosis, treatment, preventative strategies, and zoonotic implications are discussed. ETIOLOGY Babesiosis is caused by hemoprotozoa of the genus Babesia. Numerous species of Babesia exist worldwide. An increased incidence of babesiosis is described, especially in North America. The babesial organism spends the majority of its life cycle within the erythrocyte of the definitive host, resulting in hemolysis, with or without systemic complications. DIAGNOSIS Definitive diagnosis depends on direct visualization of the organism on blood smear or polymerase chain reaction. A positive serologic antibody test indicates exposure with or without active infection. THERAPY Antiprotozoal drugs, antimicrobials, and supportive care are the mainstays of babesiosis therapy. PROGNOSIS Prognosis depends on the severity of disease, which in turn depends on both organism and host factors. Clinical syndromes associated with a poorer prognosis include red biliary syndrome, acute renal failure, acute respiratory distress syndrome, neurologic dysfunction, acute pancreatitis, cardiac dysfunction, and hypoglycemia.
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Affiliation(s)
- Ashley L Ayoob
- Department of Emergency and Critical Care Medicine, Animal Medical Center, New York, NY 10065, USA.
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Abstract
OBJECTIVE To review and summarize current information regarding the etiology, clinical presentation, diagnosis, treatment, and prognosis of feline babesiosis, especially with regard to features distinct from canine babesiosis. ETIOLOGY Babesiosis is caused by hemoprotozoa of the genus Babesia. Numerous species of Babesia exist worldwide. The babesial organism spends the majority of its life cycle within the erythrocyte of the definitive host, resulting in hemolysis, with or without systemic complications. DIAGNOSIS Definitive diagnosis depends on direct visualization of the organism on blood smear or a positive polymerase chain reaction. Positive serologic tests indicate only exposure, with or without active infection. THERAPY Antiprotozoal drugs and supportive care are the mainstays of therapy. Primaquine phosphate is considered the treatment of choice in cats. PROGNOSIS Prognosis depends on the severity of disease, which in turn depends on both organism and host factors. Mortality rates of 15-20% are reported.
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Affiliation(s)
- Ashley L Ayoob
- Department of Emergency and Critical Care Medicine, Animal Medical Center, 510 East 62nd St, New York, NY 10065, USA.
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11
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Lin MY, Huang HP. Use of a doxycycline-enrofloxacin-metronidazole combination with/without diminazene diaceturate to treat naturally occurring canine babesiosis caused by Babesia gibsoni. Acta Vet Scand 2010; 52:27. [PMID: 20416095 PMCID: PMC2874561 DOI: 10.1186/1751-0147-52-27] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 04/24/2010] [Indexed: 11/14/2022] Open
Abstract
Canine babesiosis is an important worldwide, tick-borne disease caused by hemoprotozoan parasites of the genus Babesia. Babesia gibsoni is the predominant species that causes canine babesiosis in Taipei, Taiwan. It is a small pleomorphic intraerythrocytic parasite that can cause erythrocyte destruction and hemolytic anemia. Efficacy of oral administration of a doxycycline-enrofloxacin-metronidazole combination with and without injections of diminazene diaceturate in the management of naturally occurring canine babesiosis caused by B. gibsoni was evaluated retrospectively. The overall efficacy of this combination of doxycycline-enrofloxacin-metronidazole in conjunction with and without administration of diminazene diaceturate was 85.7% and 83.3%, respectively; with a mean recovery time of 24.2 and 23.5 days, respectively. Concomitant use of intramuscular diminazene diaceturate may not improve the efficacy of a doxycycline-enrofloxacin-metronidazole combination in management of canine babesiosis caused by B. gibsoni.
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Canine Hepatozoonosis and Babesiosis, and Feline Cytauxzoonosis. Vet Clin North Am Small Anim Pract 2009; 39:1035-53, v. [DOI: 10.1016/j.cvsm.2009.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Abstract
Canine babesiosis is a clinically significant emerging vector-borne disease caused by protozoan haemoparasites. This review article considers recent literature pertaining to the taxonomic classification of Babesia and Theileria species affecting dogs and the geographical distribution of these parasites. The diagnosis of canine babesiosis by traditional, molecular and serological methods is reviewed, together with recent advances in our understanding of the pathophysiology of piroplasmosis, and of the treatment and prevention of this disease.
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14
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In vitro evaluation of the growth inhibitory activities of 15 drugs against Babesia gibsoni (Aomori strain). Vet Parasitol 2008; 157:1-8. [DOI: 10.1016/j.vetpar.2008.07.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Revised: 06/25/2008] [Accepted: 07/15/2008] [Indexed: 11/24/2022]
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15
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Dantas-Torres F. Canine vector-borne diseases in Brazil. Parasit Vectors 2008; 1:25. [PMID: 18691408 PMCID: PMC2533296 DOI: 10.1186/1756-3305-1-25] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 08/08/2008] [Indexed: 11/24/2022] Open
Abstract
Canine vector-borne diseases (CVBDs) are highly prevalent in Brazil and represent a challenge to veterinarians and public health workers, since some diseases are of great zoonotic potential. Dogs are affected by many protozoa (e.g., Babesia vogeli, Leishmania infantum, and Trypanosoma cruzi), bacteria (e.g., Anaplasma platys and Ehrlichia canis), and helminths (e.g., Dirofilaria immitis and Dipylidium caninum) that are transmitted by a diverse range of arthropod vectors, including ticks, fleas, lice, triatomines, mosquitoes, tabanids, and phlebotomine sand flies. This article focuses on several aspects (etiology, transmission, distribution, prevalence, risk factors, diagnosis, control, prevention, and public health significance) of CVBDs in Brazil and discusses research gaps to be addressed in future studies.
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Affiliation(s)
- Filipe Dantas-Torres
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, PO Box 7472, Recife, 50670420, Pernambuco, Brazil.
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16
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Suzuki K, Wakabayashi H, Takahashi M, Fukushima K, Yabuki A, Endo Y. A Possible treatment strategy and clinical factors to estimate the treatment response in Bebesia gibsoni infection. J Vet Med Sci 2008; 69:563-8. [PMID: 17551236 DOI: 10.1292/jvms.69.563] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The effectiveness of combination therapy using clindamycin, metronidazole and doxycycline against canine babesiosis, and the usefulness of platelet count and the plasma C-reactive protein (CRP) concentration as an estimation factor for treatment, were evaluated in four dogs experimentally infected with Babesia gibsoni. The combination therapy successfully eliminated B. gibsoni in peripheral blood in 3 of 4 dogs, however the remaining dog showed obvious uncontrolled relapse after a temporary recovery. In addition, it was shown that CRP levels decreased in an inverse relationship to the recovery of packed cell volume and therefore CRP levels could be used as an optional clinical marker to estimate the response to treatment.
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Affiliation(s)
- Koretoki Suzuki
- Laboratory of Veterinary Internal Medicine, Faculty of Agriculture, Kagoshivma University, Korimoto, Kagoshima, Japan
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17
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Dantas-Torres F, Figueredo LA. Canine babesiosis: A Brazilian perspective. Vet Parasitol 2006; 141:197-203. [PMID: 16962707 DOI: 10.1016/j.vetpar.2006.07.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2006] [Revised: 06/19/2006] [Accepted: 07/24/2006] [Indexed: 11/19/2022]
Abstract
Canine babesiosis is highly endemic in Brazil, caused by Babesia canis and Babesia gibsoni, both transmitted by Rhipicephalus sanguineus ticks. The present review argues for a more adequate method of characterizing the Babesia species infecting dogs and cats in different Brazilian endemic zones. It advocates for a comprehensive understanding of the biology of R. sanguineus ticks under Brazilian conditions in order to define the more effective preventive strategies against canine babesiosis and calls for partnerships between the public and private sectors for research on canine babesiosis and other vector-borne diseases in Brazil.
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Affiliation(s)
- Filipe Dantas-Torres
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, C.P. 7472, Recife 50670-420, Pernambuco, Brazil.
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18
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Máthé A, Vörös K, Németh T, Biksi I, Hetyey C, Manczur F, Tekes L. Clinicopathological changes and effect of imidocarb therapy in dogs experimentally infected with Babesia canis. Acta Vet Hung 2006; 54:19-33. [PMID: 16613023 DOI: 10.1556/avet.54.2006.1.3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this study one spleen-intact dog (A) and two splenectomised dogs (BSE, CSE) were infected with Babesia canis. All animals developed an acute disease characterised by fever, haemoglobinuria and anaemia, the latter being more severe in the splenectomised dogs. Fever and parasitised red blood cells were detected for three days after imidocarb treatment in the splenectomised animals. Haematological abnormalities included regenerative anaemia, thrombocytopenia and leukopenia (due to neutropenia and lymphopenia) in the acute phase, soon followed by leukocytosis, neutrophilia and left shift a few days later. Acute hepatopathy was detected in all dogs with elevated ALT activity, which was more seriously altered in the splenectomised dogs. Diffuse changes in liver structure and hepatomegaly were seen by ultrasonography. Liver biopsy and histology revealed acute, non-purulent hepatitis in the splenectomised dogs. Both splenectomised dogs were successfully cured after collection of 400 ml highly parasitised blood, proving that large-amount antigen production is possible with rescuing the experimental animals. Whole blood transfusion, imidocarb and supportive care with infusions, antipyretics, glucocorticoids and diuretics were applied. The spleen-intact dog clinically recovered after receiving supportive treatment, with no imidocarb therapy. Microbial infections developed in both splenectomised animals (BSE: haemobartonellosis, CSE: osteomyelitis caused by Escherichia coli), probably as a consequence of immunosuppression after splenectomy and glucocorticoid therapy.
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Affiliation(s)
- A Máthé
- Department and Clinic of Internal Medicine, Faculty of Veterinary Science, Szent István University, H-1078 Budapest, Hungary.
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19
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Davoust B, Keundjian A, Rous V, Maurizi L, Parzy D. Validation of chemoprevention of canine monocytic ehrlichiosis with doxycycline. Vet Microbiol 2005; 107:279-83. [PMID: 15863288 DOI: 10.1016/j.vetmic.2005.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2004] [Revised: 02/03/2005] [Accepted: 02/04/2005] [Indexed: 11/21/2022]
Abstract
Epidemiological (cohort follow-up) and laboratory techniques studies were done to validate a programme of chemoprevention of canine monocytic ehrlichiosis (CME) with this molecule. 614 dogs returning to France after having spent at least 4 months in a CME-endemic area (Africa, Guyana, Middle-East, etc.) were the object of systematic serological testing by indirect immunofluorescence (IFA). The dogs were given 100 mg of doxycycline per os daily for chemoprevention of CME. In addition, HPLC (high performance liquid chromatography) was used to determine plasma levels of doxycycline in 124 of the dogs. The CEM mortality and morbidity rates for the 614 dogs in the chemoprevention programme were nil. The seroconversion rate was 4% (24/614). Seropositive dogs (low titres) were asymptomatic and generally became seronegative after treatment. A study done on 10 dogs shows that doxycyclinaemia was 1.2 (0.94-1.53) microg/ml 2 h after the drug had been administered. After 24 h, the residual concentration was 0.34 (0.26-0.44) microg/ml. Blind doxycyclinaemia tests done on 110 dogs living in Africa (the results for four dogs were nil and therefore eliminated from the study) showed that the minimum observed concentration was always greater than 0.2 microg/ml. Given that, as concerns infection with Ehrlichia spp., the minimum inhibitory concentration of doxycycline is < or = 0.03 microg/ml, dogs receiving chemoprevention treatment should be protected.
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Affiliation(s)
- Bernard Davoust
- Direction Régionale du Service de Santé des Armées, BP 16, 69998 Lyon Armées, France.
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20
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Abstract
Human infections with Babesia species, in particular Babesia microti, are tick-borne illnesses that are being recognised with increased frequency. Coinfection with ehrlichiosis and Lyme disease is also being recognised as an important feature of these tick-borne illnesses. Despite the superficial resemblance of Babesia to malaria, these piroplasms do not respond to chloroquine or other similar drugs. However, the treatment of babesiosis using a clindamycin-quinine combination has been successful. Data in animal models and case-reports in humans have suggested that an atovaquone-azithromycin combination is also effective. This was confirmed in a recent prospective, open, randomised trial of clindamycin-quinine versus azithromycin-atovaquone. This paper reviews the literature on the treatment of human babesiosis and the animal models of these human pathogens.
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Affiliation(s)
- Louis M Weiss
- Division of Infectious Diseases, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Room 504 Forchheimer Building, Bronx, New York, 10461, USA.
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Tarello W. Dermatitis associated with Dirofilaria (Nochtiella) repens microfilariae in dogs from central Italy. Acta Vet Hung 2002; 50:63-78. [PMID: 12061238 DOI: 10.1556/avet.50.2002.1.9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Pruritic dermatitis associated with Dirofilaria (Nochtiella) repens microfilariae in the blood was diagnosed in 22 dogs from Fermo (Central Italy). According to the history, previous unsuccessful treatments with corticosteroids, antibiotics, restricted diet, flea control, levamisole and ivermectin were recorded in 17 dogs (77.3%). The combined filtration tests and antigen tests, performed during the study, were negative for Dirofilaria immitis and Acanthocheilonema reconditum in each case. Dermatological lesions included erythema, papules, single or multifocal alopecia, eczema, lichenification, crusting and nodules. All dogs had pruritus. Concurrent babesiosis was diagnosed in the blood smears of each case (100%), and 60% of the dogs were found to be carriers of canine granulocytic ehrlichiosis (CGE). Three dogs (13.6%) were positive for leishmaniosis. Eradication of the concurrent infections followed by specific macro- and microfilaricide treatment led to complete recovery from the dermatological syndrome. The main conclusion of the study is that D. repens infection can be more pathogenic than is currently considered, and it is apparently an opportunistic disease with serious dermatological consequences.
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Abstract
Zoonotic babesiosis has received increased attention recently, due mainly to the interest in tick-borne zoonotic diseases generated by the emergence of Lyme borreliosis and to increased awareness of diagnostic and treatment difficulties associated with co-infection cases. The vast majority of European cases have been caused by Babesia divergens in splenectomised patients, and although rare, this disease is very dangerous, requiring aggressive treatment. The use of atovaquone, a recently developed anti-protozoan agent for human treatment, may be considered in future cases. Most human babesiosis caused by B. microti have occurred in the north-eastern states of the USA and can affect spleen-intact as well as asplenic patients. The majority of infections are subclinical or follow a mild chronic course, but dangerous acute infections can occur in immunocompromised patients. The role of B. microti in apparently unresponsive cases of Lyme borreliosis and treatment of co-infections require further investigation. The zoonotic potential of B. microti in Europe is still unresolved, but the vector competence of Ixodes ricinus for at least some European (and American) strains has been demonstrated.
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Affiliation(s)
- Jeremy Gray
- ERM Department, University College Dublin, Republic of Ireland.
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