Babesia Can Cause Hemolytic Anemia
2010 Babesia Medicine

Babesia is at emerging red blood cell infection missed in patients for reasons I will discuss later. Routine labs miss it about 99% of the time and some who examine red blood cells, only look for 2 minutes and others use very low power with no oil — you are never going to see it with such rushed and poor examinations.

New Babesia species are found every season, and ones that infect humans are exploding in number.

Antibody testing is poor, requires huge levels to be a positive, and assume Bartonella is not present which can lower and hide Babesia titers since Bartonella lowers immune chemicals.

We have published four textbooks on Babesia, looked at "cures," and examined what really works in inherited patients and our patients. Routine testing and treatment is stuck in the 80's and 90's. For example, using Mepron 750 mg twice a day lowers some Babesia species but is no cure. Most patients will relapse at some future time or be hurt in a manner that does not appear to be Babesia.

Zithromax at a mere 500 mg/per day is pathetic. Newer studies and research show different dosing is needed as an augmenting agent. The use of artemisinin is simply sad failed 1990's medicine.

1. Vet Parasitol. 2009 Aug 29. [Epub ahead of print]

Babesia divergens experimental infection of spleen-intact sheep results in long-lasting parasitemia despite a strong humoral response: Preliminary results.

Moreau E, Jouglin M, Chauvin A, Malandrin L.

Ecole Nationale Vétérinaire, UMR 1300 BioEpAR, ENVN, Atlanpole – La Chantrerie, BP 40706, F-44307 Nantes cedex 03, France.

Babesia divergens is an intraerythrocytic Apicomplexa and the main agent of bovine babesiosis in Europe. The infection in cattle develops in 2 phases: an acute phase with hemolytic anemia and a chronic phase with asymptomatic persistence of the parasite for several years. The acute phase of B. divergens infection can be studied using the gerbil (Meriones unguiculatus) as a laboratory model but unlike cattle, this animal rapidly eliminates the parasite. An experimental model to study the chronic phase of infection was therefore developed by our laboratory. Spleen-intact sheep, with a potential full immune response, were inoculated with infected red blood cells (iRBC) or with free merozoites, by several routes (intraperitoneal, intravenous or subcutaneously). No clinical signs were ever observed but the installation of a persistent low level infection was shown in sheep with susceptible erythrocytes (able to sustain B. divergens growth in vitro). Neither feature was observed in sheep with non-susceptible erythrocytes. IgG production, involving both IgG1 and IgG2, was mainly directed against the major merozoite surface antigen Bd37, similar to the humoral immune response described in naturally infected cattle. The use of spleen-intact sheep to study the immune response to B. divergens is discussed.

PMID: 19765903 [PubMed - as supplied by publisher]

2. J Zoo Wildl Med. 2009 Mar;40(1):152-9.

Diagnosis and treatment of Babesia odocoilei in captive reindeer (Rangifer tarandus tarandus) and recognition of three novel host species.

Bartlett SL, Abou-Madi N, Messick JB, Birkenheuer A, Kollias GV.

Section of Wildlife Health, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA. slb35@cornell.edu

Two captive reindeer (Rangifer tarandus tarandus) at a New York zoological institution were diagnosed with Babesia odocoilei. Clinical signs consistent with acute babesiosis included fever, hemoglobinuria, and hemolytic anemia. Both episodes were precipitated by stressful events that may have compromised their immunocompetence. The diagnosis was confirmed by visualization of intraerythrocytic parasites on stained blood smears, polymerase chain reaction, and speciation of the Babesia by sequencing a hypervariable region of the 18S rRNA gene. One reindeer died with gross and histopathologic lesions, including pigmentary nephrosis with severe acute tubular degeneration and necrosis secondary to intravascular hemolysis. A second reindeer was successfully treated with supportive care and an antiprotozoal, imidocarb dipropionate (Imizol, 12%, Schering-Plough Animal Health, Union, New Jersey 07083, USA) at 3 mg/kg s.c. or i.m. s.i.d. on days 1, 2, 6, 9, and 21. Two other reindeer in the exhibit tested negative for Babesia by polymerase chain reaction but were treated with imidocarb dipropionate as prophylaxis while final testing results were pending. Additionally, B. odocoilei was identified in three novel asymptomatic host species within the collection: yak (Bos grunniens), muntjac (Muntiacus reevesi), and markhor goat (Caprafalconeri). Due to the high morbidity and mortality associated with acute babesiosis, captive reindeer should receive tick prevention, be tested for subclinical infections in endemic areas, and receive aggressive treatment for acute infections when clinical babesiosis is suspected.

PMID: 19368255 [PubMed - indexed for MEDLINE]

3. Vector Borne Zoonotic Dis. 2009 Mar 9. [Epub ahead of print]

Epidemiologic and Clinical Surveys in Dogs Infected with Babesia gibsoni in South Korea.

Lee MJ, Yu DH, Yoon JS, Li YH, Lee JH, Chae JS, Park J.

Department of Veterinary Internal Medicine, College of Veterinary Medicine, Jeonju, Jeonbuk 561-756 Chonbuk National University, Jeonju, Jeonbuk, Korea.

Clinically diagnosed cases of Babesia gibsoni infection in dogs were evaluated on the basis of polymerase chain reaction (PCR) results and nucleotide sequences of the 18S rRNA gene. Twenty-nine of 117 submitted dogs were PCR positive. The breed of dogs infected with B. gibsoni varied; however, pit bull terriers were the breed most often infected. The infection rate was higher in densely populated regions and in male dogs. Young dogs (age < 3 years) were more sensitive to B. gibsoni infection, and 6 out of the 29 infected dogs had a history of tick exposure. The clinical signs observed during physical examination were related to canine babesiosis, and many dogs showed symptoms similar to those associated with anemia. The results of hematologic analysis revealed severe hemolytic anemia and thrombocytopenia in the infected dogs. However, the blood smears of 29 infected dogs showed very low levels of parasitemia. Nucleotide sequencing of the PCR products revealed that the 18S rRNA gene sequences of B. gibsoni in South Korea were very close to those reported in Spain, Japan, and the United States.

PMID: 19271995 [PubMed - as supplied by publisher]

4. Vox Sang. 2008 Nov;95(4):331-4.

Transmission of Babesia microti by blood transfusion in Texas.

Cangelosi JJ, Sarvat B, Sarria JC, Herwaldt BL, Indrikovs AJ.

Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0435, USA.

In the USA, seasonal tickborne transmission of Babesia microti occurs in the Northeast and upper Midwest. A resident of Texas became infected through a red blood cell transfusion from an asymptomatic local donor who had summered in Massachusetts. The patient's infection was diagnosed by blood smear examination in January, 7 weeks post-transfusion. He died 1 week later from variceal haemorrhage complicated by haemolysis. Premortem patient specimens and archived blood from the donor unit tested positive for B. microti antibodies and DNA. Babesiosis should be included in the differential diagnosis of post-transfusion haemolytic anaemia or thrombocytopenia, regardless of the geographical region or season.

PMID: 19138264 [PubMed - indexed for MEDLINE]

5. Heart Lung. 2008 Nov-Dec;37(6):481-4. Epub 2008 Sep 30.

Fever of unknown origin (FUO) due to babesiosis in a immunocompetent host.

Cunha BA, Cohen YZ, McDermott B.

Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.

Fevers of unknown origin (FUOs) are defined as prolonged fevers of 101 degrees F or greater lasting 3 or more weeks that remain undiagnosed after comprehensive inpatient/outpatient laboratory testing. Tick-borne infections are uncommon causes of FUOs. Any infectious disease accompanied by prolonged fevers can present as an FUO if the diagnosis is not suspected or if specific laboratory testing is not done to confirm the diagnosis. Babesiosis is transmitted by the Ixodes scapularis ticks endemic to areas in the northeastern United States. We present the case of a 73-year-old, non-human immunodeficiency virus, male from Long Island who presented with FUO for 6 weeks. As with malaria, there are usually few or no localizing signs in babesiosis. During the patient's hospitalization, babesiosis was suspected on the basis of nonspecific laboratory findings, that is, relative lymphopenia, thrombocytopenia, thrombocytopenia, and an elevated lactate dehydrogenase. When babesiosis was considered in the differential diagnosis, stained blood smears demonstrated the red blood cell inclusions of babesiosis. In the hospital, the patient developed noncardiac pulmonary edema, which rapidly resolved which has been described as a rare complication of babesiosis. He also had an elevated immunoglobulin-M Lyme titer indicating coinfection with Lyme disease. Although his hemolytic anemia persisted for weeks, he only had 3% parasitemia and intact splenic function. We believe this to be the first case of babesiosis presenting as an FUO in a normal host.

PMID: 18992633 [PubMed - indexed for MEDLINE]

6. Vet Parasitol. 2008 Nov 7;157(3-4):211-21. Epub 2008 Jul 26.

Babesia canis canis and Babesia canis vogeli clinicopathological findings and DNA detection by means of PCR-RFLP in blood from Italian dogs suspected of tick-borne disease.

Solano-Gallego L, Trotta M, Carli E, Carcy B, Caldin M, Furlanello T.

Laboratorio d'Analisi Veterinarie, Via sorio 114c, 35141 Padua, Italy. lsolano@rvc.ac.uk

The aims of this study were to determine the presence of Babesia spp. in blood samples from Italian dogs with clinical signs compatible with tick-borne diseases by means of PCR-restriction fragment length polymorphism (RFLP) and describe the clinicopathological findings of dogs with Babesia infection. We evaluated the majority of canine babesiosis cases by means of clinical history, physical examination, hematological, biochemical, serum electrophoresis, urinalysis and hemostatic tests. Forty-five out of 164 canine blood samples studied were positive to Babesia PCR-RFLP with the following results: Babesia canis canis (n=34) and Babesia canis vogeli (n=11). The majority of B. c. canis infections were detected in Northern Italy (29.1%; 30/103). B. c. vogeli cases were detected mainly in Central and Southern Italy (16.3%; 10/61). Only one B. c. vogeli was detected in Northern Italy (0.9%; 1/103). Three positive samples to B. c. canis and four positive samples to B. c. vogeli were selected for sequencing of a fragment of the 18S rRNA gene (410bp) for further molecular characterization. The sequence obtained from all seven dogs was 99/100% homologous to sequences from B. c. canis and B. c. vogeli, respectively, present in GenBank. Sixty-two percent of dogs infected with B. c. canis had recently travelled on a hunting trip to East European countries. The main acute clinical signs were dehydration, apathy, anorexia and fever. The majority of dogs infected with B. c. canis presented at initial clinical examination mild to severe thrombocytopenia, hyperfibrinogenemia, mild to moderate normocytic-normochromic non-regenerative anemia, hemolysis and neutropenia. The urinalysis showed hemoglobinuria in 13/19 dogs suggesting intravascular hemolysis. Dogs with B. c. canis infection had high levels of C-reactive protein. Hypoalbuminemia was present in 17/26 dogs. The 11 cases of B. c. vogeli infection did not present a homogenous clinicopathological pattern. B. c. vogeli infections were observed in young dogs causing hemolytic anemia and in adult/old does that frequently presented predisposing factors such as splenectomy or immunocompromised conditions. In conclusion, this study demonstrates the presence of B. c. canis and B. c. vogeli in Italian sick dogs and differences in clinicopathological pattern in these two species of B. canis.

PMID: 18789581 [PubMed - indexed for MEDLINE]

7. Wiad Parazytol. 2008;54(2):109-15.

[Dogs babesiosis--still actually problem]

[Article in Polish]

Adaszek Ł, Winiarczyk S.

Katedra Epizootiologii i Klinika Chorób Zakaźnych, Wydział Medycyny Weterynaryjnej, Akademia Rolnicza, ul. Głeboka 30, 20-612 Lublin. ukaszek0@wp.pl

Babesiosis (piroplasmosis) is a tick-borne disease with a symptoms of hemolytic anemia. For the first time babesiosis was described in dogs in United States in 1934. The etiological factor of this disease in Poland is protozoa Babesia canis, and its vector--Dermacentor-tick. The most common symptoms of babesiosis are: icterus, hemoglobinuria, occasionally vomits and diarrhea. The biochemical examination of blood serum from sick animals can reveal the increase of activity of AST, ALT, the increase of total bilirubine, urea and creatynine concentrations. The results of hematological examinations can show anemia, leucopenia and thrombocytopenia. The diagnosis of babesiosis bases on anamnesis, clinical examinations of dogs, microscopical examinations of blood smears from sick animals; IF-assay and PCR can also be helpful for the diagnosis of babesiosis. Till now does not exist the effective immunoprophylaxis against this disease. Babesiosis is well-known disease, however there are still problems with therapy of infected animals. Most effective drug in therapy of dog piroplasmosis is imidocarb, but sometimes can be observed side effects after it application. It is possible that the genetically differences which are detected in subspecies may have an influence on the severity of disease and the effectiveness of therapy.

PMID: 18702315 [PubMed - indexed for MEDLINE]

8. J Zoo Wildl Med. 2007 Jun;38(2):285-91.

Laboratory findings in acute Cytauxzoon felis infection in cougars (Puma concolor couguar) in Florida.

Harvey JW, Dunbar MR, Norton TM, Yabsley MJ.

Department of Physiological Sciences, Box 100144, College of Veterinary Medicine, University of Florida, Gainesville, Florida 32610, USA. harveyj@mail.vetmed.ufl.edu

Intraerythrocytic piroplasms, morphologically indistinguishable from Cytauxzoon felis, were identified in stained blood films from more than one third of free-ranging cougars (Puma concolor couguar) in southern Florida in a study that failed to demonstrate negative effects of piroplasm infection on measured hematologic parameters. However, a recent study with a nested 18s rRNA polymerase chain reaction (PCR) assay identified only 9% of the free-ranging cougars in southern Florida as infected with C. felis but found 83% of these animals were infected with an unnamed small Babesia sp. In this study, hematology and clinical chemistry parameters were determined during the initial appearance of piroplasms in stained blood films of three western cougars housed in northern Florida. One animal became ill, but the remaining two animals did not exhibit clinical signs of disease. The hematocrit decreased in all three cougars concomitant with the first recognized parasitemia. A regenerative response to anemia (increased polychromasia, increased mean cell volume, and increased red cell distribution width) was recognized in two cougars that were examined twice during the following 2 weeks. Thrombocytopenia and probable leukopenia occurred in one animal. The most consistent clinical chemistry findings were increased serum bilirubin concentrations and increased alanine aminotransferase and aspartate aminotransferase activities at the time of initial recognition of parasitemia. Serum protein findings were not consistent in these cougars. The use of PCR and determination of 18S rRNA gene sequences in the blood from these three animals revealed infection with C. felis, but not with the Babesia sp. In this report, we demonstrate that mild hemolytic anemia, and probably liver injury, occurs concomitant with the initial discovery of C. felis piroplasms in stained blood films.

PMID: 17679513 [PubMed - indexed for MEDLINE]

9. Eur J Clin Microbiol Infect Dis. 2007 Jul;26(7):505-8.

Pulmonary complications of babesiosis: case report and literature review.

Cunha BA, Nausheen S, Szalda D.

Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, NY 11501, USA. EMcCaffrey@winthrop.org

Reported here is a rare case of babesiosis with pulmonary complications followed by a review of the literature. Babesiosis presents clinically as a malaria-like illness with fever, chills, headache, fatigue with lymphopenia, atypical lymphocytes, mildly or transiently elevated serum transaminases, thrombocytopenia, and increased lactate dehydrogenase (LDH) levels. The diagnosis of babesiosis is based on identification of Babesia spp. on a peripheral blood smear. Babesiosis is usually mild in normal hosts, but it may be severe or even fatal in asplenic patients. Pulmonary manifestations are rare in babesiosis, but non-cardiogenic pulmonary edema (NCPE) is the most frequent manifestation. NCPE in babesiosis does not appear to be related to the degree of parasitemia or splenic function and its onset may be early or late. NCPE usually resolves rapidly with supportive treatment; it is rarely fatal. Clinicians should suspect NCPE in patients with babesiosis who acutely develop shortness of breath and have chest radiograph findings compatible with acute pulmonary edema without cardiomegaly or pleural effusions.

PMID: 17558489 [PubMed - indexed for MEDLINE]

10. Acta Vet Hung. 2006 Sep;54(3):367-85.

Clinical manifestations of canine babesiosis in Hungary (63 cases).

Máthé A, Vörös K, Papp L, Reiczigel J.

Department and Clinic of Internal Medicine, Faculty of Veterinary Science, Szent István University, H-1400 Budapest, P.O. Box 2, Hungary. Mathe.Akos@aotk.szie.hu

Clinical observations of Babesia canis infection in 63 dogs during a 1-year period are summarised, demonstrating the pathogenicity of the Babesia strain endemic in Hungary. Most patients had babesiosis in the spring and autumn, correlating with the seasonal activity of ticks. Male animals appeared in higher numbers, probably due to an overrepresentation of outdoor dogs. Uncomplicated babesiosis was diagnosed in 32 cases. The disease affected dogs of any age in this study. Symptoms were similar to those published from other parts of the world: lethargy, fever, splenomegaly, pallor, icterus, haemoglobinuria and presence of ticks were the most common observations. Thrombocytopenia, lymphopenia and neutropenia were frequent haemogram changes. Imidocarb appeared to be highly effective in eliminating the Babesia infection. Thirty-one animals demonstrated babesiosis with complications. Most Rottweilers (7/9) developed complicated disease. Old age was a risk factor for multiple complications. Multiple organ manifestations had poor prognosis. Hepatopathy (44%), pancreatitis (33%), acute renal failure (ARF; 31%) and disseminated intravascular coagulation (DIC; 24%) were frequent complications, while immune-mediated haemolytic anaemia (IMHA; 10%), acute respiratory distress syndrome (ARDS; 6%) and cerebral babesiosis (3%) were rarely observed. There was a significant difference between the mean age of dogs having uncomplicated disease, babesiosis with a single complication and babesiosis with multiple complications (3.4, 4.8 and 8.6 years, respectively, p < 0.001). The recovery rate (78, 68 and 25%, respectively, p = 0.005) and mortality rate (3, 21 and 67%, respectively, p < 0.001) also tended to differ significantly in these groups. Systemic inflammatory response syndrome (SIRS) and DIC are two possible pathways leading to multiple organ dysfunction syndrome (MODS) in babesiosis. DIC was found to predict MODS more sensitively in this study than SIRS: there were 6 animals developing MODS out of 11 identified with DIC, while only 5 dogs developed MODS out of 22 having SIRS.

PMID: 17020140 [PubMed - indexed for MEDLINE]

11. Vet J. 2007 Jul;174(1):129-32. Epub 2006 Aug 9.

Clinico-pathological findings and coagulation disorders in 45 cases of canine babesiosis in Spain.

Ruiz de Gopegui R, Peñalba B, Goicoa A, Espada Y, Fidalgo LE, Espino L.

Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universitat Autònoma de Barcelona, Spain. rafael.ruiz@uab.es

A retrospective study of clinical cases of babesiosis in dogs examined at the Veterinary Teaching Hospital, Rof Codina, from January 2003 to October 2004 is presented. The diagnosis was confirmed by direct observation of large piroplasms in stained blood smears. Dogs with concurrent diseases were excluded from the study. Clinical signs, complete blood count, serum biochemistry and hemostasis profiles were obtained. The observed clinical signs were due to hemolytic anemia and inflammatory responses but the most relevant clinico-pathological findings were related to alterations in hemostasis. All dogs presented with thrombocytopenia and 20% had disseminated intravascular coagulation syndrome. Anemia of variable severity was observed in most of the dogs.

PMID: 16901737 [PubMed - indexed for MEDLINE]

12. Vaccine. 2006 Jan 30;24(5):613-21. Epub 2005 Sep 2.

Hydrophobic moeties in recombinant proteins are crucial to generate efficient saponin-based vaccine against Apicomplexan Babesia divergens.

Delbecq S, Hadj-Kaddour K, Randazzo S, Kleuskens J, Schetters T, Gorenflot A, Précigout E.

Laboratoire de Biologie Cellulaire et Moleculaire, ERT 1038 Vaccination anti-parasitaire, Faculté de Pharmacie, 15 Avenue Charles Flahault, BP 14 491, 34093 Montpellier cedex 05, France.

Throughout Europe, bovine babesiosis is mainly caused by Babesia divergens, an Apicomplexan parasite transmitted by tick bites. The intra-erythrocytic development of B. divergens merozoites leads to haemolytic anaemia, and bovine babesiosis is responsible for economic losses in the agro-business industry. A totally efficient recombinant vaccine based on the merozoite surface protein Bd37 and saponin QuilA was recently described. In the present study we determined that protective immunity elicited by the Bd37 recombinant protein was related to the presence of hydrophobic residues in the protein. Using polymeric fusion of Bd37 as well as cell-free in vitro protein expression, we successfully expressed recombinant proteins containing hydrophobic sequences without the need of GST fusion. We used different hydrophobic sequences and different recombinant Bd37 proteins to demonstrate that antigen hydrophobicity affects the immune system, turning an inefficient protein into a 100% protective vaccine. Some hypotheses about the hydrophobic effect and its potential application to other parasitic protozoa vaccine are also discussed.

PMID: 16199111 [PubMed - indexed for MEDLINE]

13. J Am Vet Med Assoc. 2005 Sep 15;227(6):942-7.

Geographic distribution of babesiosis among dogs in the United States and association with dog bites: 150 cases (2000-2003).

Birkenheuer AJ, Correa MT, Levy MG, Breitschwerdt EB.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.

OBJECTIVE: To identify the geographic distribution of babesiosis among dogs in the United States and determine, for dogs other than American Pit Bull Terriers (APBTs), whether infection was associated with a recent dog bite. DESIGN: Retrospective study. ANIMALS: 150 dogs. PROCEDURE: Canine blood samples submitted to the North Carolina State University Vector-Borne Disease Diagnostic Laboratory between May 2000 and October 2003 for which results of a Babesia-specific polymerase chain reaction assay were positive were identified, and breed and geographic origin of dogs from which samples were obtained were recorded. History and hematologic abnormalities for dogs that were not APBTs were recorded, and possible associations with a recent dog bite were examined. RESULTS: Dogs positive for Babesia DNA were located in 29 states and 1 Canadian province (Ontario). Babesia gibsoni was the most commonly detected species, with B gibsoni DNA detected in blood samples from 131 of 144 (91%) dogs. Of the 131 dogs positive for B gibsoni DNA, 122 (93%) were APBTs. Of the 10 dogs positive for Babesia canis vogeli DNA, 6 were Greyhounds. In dogs other than APBTs, there was an association between having recently been bitten by another dog, particularly an APBT, and infection with B gibsoni. CONCLUSIONS AND CLINICAL RELEVANCE: Results document an expansion of the known geographic range for babesiosis among dogs in the United States. Testing for babesiosis should be pursued in dogs with clinicopathologic abnormalities consistent with immune-mediated hemolytic anemia or thrombocytopenia, particularly if there is a history of a recent dog bite.

PMID: 16190594 [PubMed - indexed for MEDLINE]

14. Vet Parasitol. 2005 Nov 25;134(1-2):77-85. Epub 2005 Aug 19.

Clinicopathological findings in naturally occurring cases of babesiosis caused by large form Babesia from dogs of northeastern Italy.

Furlanello T, Fiorio F, Caldin M, Lubas G, Solano-Gallego L.

Clinica Veterinaria Privata San Marco, Laboratorio Privato d'Analisi Veterinarie San Marco, Padova, Italy.

There are few extensive studies about clinicopathological findings of spontaneous canine babesiosis caused by a large form of the parasite found in Europe. To further characterize and describe clinicopathological findings in dogs affected with this large form of Babesia in northeastern Italy, we evaluated 23 Italian dogs with canine babesiosis by means of clinical history, physical examination, hematological, biochemical, hemostatic tests, serum electrophoresis and urinalysis. Seventeen dogs (74%) had recently traveled on a hunting trip (within 5-15 days of being presented to the clinic) to Bosnia and Herzegovina (n=7), to Croatia (n=8) and to Hungary (n=2). The duration of clinical signs ranged from 1 to 5 days prior to the arrival at the clinic. The main clinical signs were dehydration (100%), apathy (74%), anorexia or decrease appetite (70%) and fever (68%). The anemia was present in 74% of the dogs and classified as mild (35%), moderate (59%) and severe (6%). In all cases, the anemia was normocytic and normochromic. Only three dogs presented erythrocyte regeneration. Seventy percent of dogs had hemolytic anemia and 30% had non-hemolytic anemia. Sixty-nine percent of dogs showed leucopenia and 74% neutropenia. Leucocitosis, due to mature neutrophilia and lymphocytosis, was present in one dog. Activated lymphocytes were noted in 61% of dogs. In all dogs, thrombocytopenia and an elevated hyperfibrinogenemia were present. Significant prolonged activated partial thromboplastin time (aPTT) was only found in one case. In four dogs, both plasma fibrinogen/fibrin degradation products (FDPs) and D-Dimer were increased. Antithrombin (AT) was slightly decreased in 11 of the 23 dogs. In the majority of cases, mild elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatinekinase (CK), total bilirubin and lactic acid and decrease of total iron and total iron binding capacity (TIBC) were present. In conclusion, the main clinicopathological findings were a mild to severe thrombocytopenia, a mild to moderate hemolytic anemia, neutropenia and hyperfibrinogenemia.

PMID: 16112810 [PubMed - indexed for MEDLINE]

15. Tijdschr Diergeneeskd. 2004 Nov 15;129(22):740-5.

[Ehrlichia and Babesia infections in dogs in The Netherlands]

[Article in Dutch]

Zandvliet MM, Teske E, Piek CJ.

Hoofdafdeling Geneeskunde van Gezelschapsdieren, Yalelaan 8, 3508 TD Utrecht. M.M.J.M.Zandvliet@vet.uu.nl

A retrospective study was performed at the Department of Clinical Sciences of Companion Animals at Utrecht University amongst 75 dogs diagnosed with a Babesia canis and/or an Ehrlichia canis infection. The majority of the dogs had visited an endemic area (most often the Mediterranean area or the Dutch Antilles), but two dogs became infected with Babesia in the Netherlands. Babesia infections were associated with a stay in an endemic area and an incubation period that are both significantly shorter (less than 3 months) than those for Ehrlichia and co-infections (more than 3 months). Reasons for the owner to seek veterinary attention (lethargy, anorexia, fever), findings from the physical examination (pale mucous membranes, hepato-/splenomegaly) and laboratory results (anemia, thrombocytopenia, hypo-albuminemia) were highly aspecific, making serology or PCR mandatory for diagnosing infections. Antigenic stimulation by the parasite sometimes resulted in immune-mediated diseases such as immune-mediated hemolytic anemia, thrombocytopenia, glomerulonefritis, and polyarthritis and in the case of ehrlichiosis in hypergammaglobulinemia. Specific therapy (imidocarb-diproprionate and/or doxycycline) was necessary, and because combined infections were common, it was considered appropriate to administer both drugs while the definitive diagnosis was being established. The prognosis was reasonably good, with almost half of all patients showing no clinical signs after treatment, although Babesia and co-infections were associated with a significantly longer survival sometimes resulted than Ehrlichia infections.

PMID: 15622893 [PubMed - indexed for MEDLINE]

16. Ann N Y Acad Sci. 2004 Oct;1026:183-6.

Feline babesiosis in South Africa: a review.

Penzhorn BL, Schoeman T, Jacobson LS.

Department of Veterinary Tropical Diseases and Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, 0110, South Africa. banie.penzhorn@up.ac.za

Babesia felis, originally identified in wild cats in the Sudan, was subsequently found to cause clinical disease in domestic cats. Although babesiosis in domestic cats has been reported sporadically from various countries, as a significant disease it appears to be a distinctly South African phenomenon. Apart from an inland focus, feline babesiosis is reported regularly only from coastal regions. The infection is assumed to be tick-borne, but the vector has not been identified. Feline babesiosis tends to be an afebrile, chronic, low-grade disease. The most frequently reported complaints by owners are anorexia and lethargy. The main clinical findings are anemia, depression, and occasionally icterus. Concurrent infections (e.g., Mycoplasma haemofelis, FeLV, FIV) may contribute to the clinical picture. Laboratory findings commonly include regenerative anemia, elevation of alanine transaminase (but not alkaline phosphatase) and total bilirubin concentrations, and a variety of electrolyte disturbances. Secondary immune-mediated hemolytic anemia can be seen occasionally. Drugs effective against other Babesia species give variable and questionable results. The drug of choice is primaquine phosphate, which effects a clinical cure but does not sterilize the infection. Repeated or chronic therapy may be required.

PMID: 15604490 [PubMed - indexed for MEDLINE]

17. J Clin Microbiol. 2004 Aug;42(8):3775-80.

Concurrent infections with vector-borne pathogens associated with fatal hemolytic anemia in a cattle herd in Switzerland.

Hofmann-Lehmann R, Meli ML, Dreher UM, Gönczi E, Deplazes P, Braun U, Engels M, Schüpbach J, Jörger K, Thoma R, Griot C, Stärk KD, Willi B, Schmidt J, Kocan KM, Lutz H.

Clinical Laboratory, University of Zurich, Switzerland. rhofmann@vetclinics.unizh.ch

Bovine anaplasmosis is a vector-borne disease that results in substantial economic losses in other parts of the world but so far not in northern Europe. In August 2002, a fatal disease outbreak was reported in a large dairy herd in the Swiss canton of Grisons. Diseased animals experienced fever, anorexia, agalactia, and depression. Anemia, ectoparasite infestation, and, occasionally, hemoglobinuria were observed. To determine the roles of vector-borne pathogens and to characterize the disease, blood samples were collected from all 286 animals: 50% of the cows were anemic. Upon microscopic examination of red blood cells, Anaplasma marginale inclusion bodies were found in 47% of the cows. The infection was confirmed serologically and by molecular methods. Interestingly, we also found evidence of infections with Anaplasma phagocytophilum, large Babesia and Theileria spp., and Mycoplasma wenyonii. The last two species had not previously been described in Switzerland. Anemia was significantly associated with the presence of the infectious agents detected, with the exception of A. phagocytophilum. Remarkably, concurrent infections with up to five infectious vector-borne agents were detected in 90% of the ill animals tested by PCR. We concluded that A. marginale was the major cause of the hemolytic anemia, while coinfections with other agents exacerbated the disease. This was the first severe disease outbreak associated with concurrent infections with vector-borne pathogens in alpine Switzerland; it was presumably curtailed by culling of the entire herd. It remains to be seen whether similar disease outbreaks will have to be anticipated in northern Europe in the future.

PMCID: 497630 PMID: 15297529 [PubMed - indexed for MEDLINE]

18. J Am Vet Med Assoc. 2003 Oct 1;223(7):1027-32, 986.

Babesia odocoilei infection in elk.

Gallatin LL, Irizarry-Rovira AR, Renninger ML, Holman PJ, Wagner GG, Sojka JE, Christian JA.

Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University West Lafayette, IN 47907, USA.

Two male North American elk from a commercial herd were evaluated because of a sudden onset of lethargy, anorexia, and voiding of red urine. These 2 elk were kept in the same pen as 4 other male elk that had died during the preceding 2 months. Laboratory analyses revealed anemia and intraerythrocytic parasites, later confirmed as Babesia odocoilei (a protozoal hemoparasite of cervids). Of the 240 elk remaining in the herd, 59 were screened for B odocoilei by microscopic evaluation of blood smears, protozoal culture of blood, and immunofluorescent antibody testing of serum. Of those 59 elk, 34 (58%) were infected with B odocoilei. Babesia odocoilei infection in elk can be fatal and should be considered in cases of sudden death or acute hemolytic anemia. Familiarity with the disease in elk is essential for practitioners because of the increasing popularity of commercial elk farming.

PMID: 14552494 [PubMed - indexed for MEDLINE]

19. N Engl J Med. 2003 Sep 18;349(12):1168-75.

Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 29-2003. A 60-year-old man with fever, rigors, and sweats.

Gutman JD, Kotton CN, Kratz A.

Family Medicine Associates, South Attleboro, Mass, USA.

Comment in: N Engl J Med. 2003 Dec 18;349(25):2467; author reply 2467.

PMID: 13679532 [PubMed - indexed for MEDLINE]

20. Vet Clin North Am Small Anim Pract. 2003 Jul;33(4):885-904, viii.

Canine babesiosis.

Boozer AL, Macintire DK.

Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Wire Road, Auburn, AL 36849, USA. boozeal@vetmed.auburn.edu

Canine babesiosis is a tickborne, protozoal, hemoparasitic disease that can cause varying degrees of hemolytic anemia, splenomegaly, thrombocytopenia, and fever. Babesia organisms frequently are classified as large or small. Large Babesia infections are attributed to one of three subspecies of Babesia canis. All small Babesia infections previously were attributed to B gibsoni, but molecular analysis and DNA sequencing have revealed that there are at least three small piroplasms infecting dogs. Correctly identifying the infectious agent is important for treatment planning and prognosis.

PMID: 12910748 [PubMed - indexed for MEDLINE]

21. Emerg Infect Dis. 2003 Feb;9(2):184-8.

Endemic babesiosis in another eastern state: New Jersey.

Herwaldt BL, McGovern PC, Gerwel MP, Easton RM, MacGregor RR.

Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA. bxh4@cdc.gov

In the United States, most reported cases of babesiosis have been caused by Babesia microti and acquired in the northeast. Although three cases of babesiosis acquired in New Jersey were recently described by others, babesiosis has not been widely known to be endemic in New Jersey. We describe a case of babesiosis acquired in New Jersey in 1999 in an otherwise healthy 53-year-old woman who developed life-threatening disease. We also provide composite data on 40 cases of babesiosis acquired from 1993 through 2001 in New Jersey. The 40 cases include the one we describe, the three cases previously described, and 36 other cases reported to public health agencies. The 40 cases were acquired in eight (38.1%) of the 21 counties in the state. Babesiosis, a potentially serious zoonosis, is endemic in New Jersey and should be considered in the differential diagnosis of patients with fever and hemolytic anemia, particularly in the spring, summer, and early fall.

PMID: 12603988 [PubMed - indexed for MEDLINE]

22. Emerg Infect Dis. 2003 Jan;9(1):116-9.

Transfusion-associated babesiosis after heart transplant.

Lux JZ, Weiss D, Linden JV, Kessler D, Herwaldt BL, Wong SJ, Keithly J, Della-Latta P, Scully BE.

Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.

We describe a 54-year-old spleen-intact man with transfusion-associated Babesia microti infection after a heart transplant. Adult respiratory distress syndrome developed in the patient, and he required mechanical ventilation. Our experiences with this patient suggest that babesiosis should be considered in the differential diagnosis of transplant patients who have fever and hemolytic anemia.

PMID: 12533293 [PubMed - indexed for MEDLINE]

23. Vet Clin Pathol. 2001;30(4):180-188.

Babesia gibsoni infection in a dog from indiana.

Irizarry-Rovira AR, Stephens J, Christian J, Kjemtrup A, DeNicola DB, Widmer WR, Conrad PA.

Department of Veterinary Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA. irizarry@vet.purdue.edu

A 10-year-old spayed female mixed-breed dog was presented to the Purdue University Veterinary Teaching Hospital (PUVTH) with complaints of persistent anemia with occasional exacerbations, anorexia, and lethargy. The dog had been presented to the referring veterinarian 2 months prior with multiple bite wounds received during a fight with 3 Pit Bull Terriers. The dog was discharged after the wounds were cleaned and surgically closed. Upon admission to the PUVTH, blood was collected for a complete blood count and biochemical analysis. Microscopic examination of peripheral blood smears revealed intraerythrocytic protozoal parasites consistent with Babesia gibsoni. Molecular analysis confirmed that the organism was B. gibsoni and that its 18S ribosomal RNA sequence was identical to that of other B. gibsoni isolates from Oklahoma, North Carolina, and Okinawa, Japan. Hematologic changes included moderately severe, regenerative, macrocytic, normochromic anemia, with poikilocytosis, polychromasia, anisocytosis, and a marked increase in nucleated RBCs. Biochemical changes included increased serum alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase activities. The dog was treated with imidocarb, but despite initial clinical improvement, the dog died 2 weeks after the first dose. A necropsy was not performed. The infection in this dog is the first reported case of B. gibsoni infection in Indiana. Because of the widespread geographical distribution of the organism, veterinarians and veterinary clinical pathologists throughout the United States should carefully examine Romanowsky-stained blood smears from patients with acute hemolytic anemia for small intraerythrocytic babesial parasites.

PMID: 12024299 [PubMed - as supplied by publisher]

24. Vet Rec. 2001 Nov 3;149(18):552-5.

Infection of dogs in north-west Spain with a Babesia microti-like agent.

Camacho AT, Pallas E, Gestal JJ, Guitián FJ, Olmeda AS, Goethert HK, Telford SR.

Laboratorio Lema & Bandin, Vigo, Spain.

During 1996 a small, ring-shaped, piroplasm was observed in blood smears from 157 dogs in north-west Spain. None of them had previously been in areas endemic for Babesia gibsoni, which was until recently the only small piroplasm known to parasitise dogs. Haematological and serum biochemistry analyses showed that almost all the dogs had an intense regenerative haemolytic anaemia and that in some cases there was evidence of renal failure. A molecular study was made of a sample of the parasite obtained in June 2000. The phylogenetic analysis showed an identity of 100 per cent with the new piroplasm, provisionally denominated as Theileria annae, and 99 per cent with Babesia microti and B. microti-Japan. The results confirm the previous observation of a new form of piroplasm (Theileria annae) which causes disease in dogs in Europe and suggest that it is endemic among the canine population in north-west Spain.

PMID: 11720208 [PubMed - indexed for MEDLINE]

25. Rinsho Ketsueki. 2000 Aug;41(8):628-34.

[First documentation of transfusion-associated babesiosis in Japan]

[Article in Japanese]

Matsui T, Inoue R, Kajimoto K, Tamekane A, Okamura A, Katayama Y, Shimoyama M, Chihara K, Saito-Ito A, Tsuji M.

Department of Medicine, Kobe University School of Medicine.

A 40-year-old man received blood transfusion in December 1998 because of gastric bleeding from a peptic ulcer. One month later, he developed febrile hemolytic anemia. Administration of high doses of glucocorticoid significantly reduced the hemolysis, but did not cure the disease. To investigate the cause of the hemolysis, the patient was transferred to our hospital in May 1999. Giemsa-stained peripheral blood smears showed Babesia parasites in the red blood cells (RBC), and PCR analysis confirmed the presence of Babesia microti DNA. The parasitemia disappeared hematologically after 2 weeks of quinine and clindamycin therapy. However, parasite DNA was still detectable in the RBC. Although treatment with oral atovaquone was given for 2 weeks, parasitemia and febrile hemolysis recurred within a month after the last treatment. Fortunately, complete remission was obtained after a second 12-week course of therapy with quinine and clindamycin. PCR analysis revealed asymptomatic Babesia infection in one of eight samples from the original blood donor. The initial steroid therapy given to the patient without an accurate diagnosis seemed to have delayed augmentation of the specific antibodies (IgG) against Babesia microti, thus prolonging the parasitemia after the initial acute stage of babesiosis.

PMID: 11020989 [PubMed - indexed for MEDLINE]

26. Transplantation. 2000 Jul 15;70(1):205-8.

Babesiosis in a renal transplant recipient acquired through blood transfusion.

Perdrizet GA, Olson NH, Krause PJ, Banever GT, Spielman A, Cable RG.

Department of Surgery, Hartford Hospital, CT 06102, USA.

BACKGROUND: The success of organ-replacement therapies has resulted in a population of chronically immunosuppressed but active people who experience increased vulnerability to tick-borne zoonoses. Several of these infections may be life threatening. Human babesiosis is an emerging zoonosis that is transmitted by the same tick that transmits Lyme disease and human granulocytic ehrlichiosis. METHODS: We briefly review these zoonoses and present a case of a renal transplant recipient who survived infection by Babesia microti contracted through blood transfusion. RESULTS: A recipient of a living-related renal transplant developed acute postoperative hemolytic anemia. The etiology of this anemia was diagnosed by peripheral red blood cell smear as Babesia microti. The patient was managed by a reduction in transplant immunosuppressive therapy and administration of clindamycin and quinine antimicrobials. CONCLUSIONS: Transplant patients may contract babesiosis after tick exposure and/or via blood transfusion. The diagnosis of babesiosis may be confused with malaria and should be included in the differential diagnosis of posttransplant hemolytic-uremic syndrome in organ transplant patients.

PMID: 10919602 [PubMed - indexed for MEDLINE]

27. Transfusion. 2000 Mar;40(3):375-80.

Fulminant babesiosis treated with clindamycin, quinine, and whole-blood exchange transfusion.

Dorman SE, Cannon ME, Telford SR 3rd, Frank KM, Churchill WH.

Division of Hematology, Department of Medicine, and the Department of Pathology, Brigham and Women's Hospital, Boston, MA 02215, USA.

BACKGROUND: Babesiosis is an increasingly recognized parasitic infection with manifestations that range from a subclinical or mild flu-like illness to life-threatening disease. Risk factors that may be associated with a more severe clinical course include immunosuppression, splenectomy, and advanced age. The most effective chemotherapeutic regimen, clindamycin plus quinine, is sometimes ineffective in cases of severe disease. CASE REPORT: A previously healthy, 58-year-old man was infected by Babesia microti, presumably through a tick bite. He developed fulminant disease characterized by severe hemolytic anemia, disseminated intravascular coagulation, acute renal failure, and respiratory failure. There was no history of splenectomy or immunodeficiency. He was given oral clindamycin (300 mg/4x/day) 2 days before admission. Oral quinine (650 mg/3x/day) was added upon hospitalization. There was no clinical improvement despite antibiotic therapy with clindamycin and quinine. On the second hospital day, a whole-blood exchange transfusion was performed to simultaneously lower the parasite load and replace the patient's plasma. With an automated blood cell separator, 87 percent of the patient's total blood volume was exchanged. As replacement fluid, 6.7 L of packed RBCs reconstituted with FFP (average Hct, 33%) was used. The patient's Hct increased from 26.9 percent before the exchange to 28.3 percent after the exchange. The percentage of parasitized RBCs decreased from 13.8 percent just before exchange to 4.2 percent immediately after exchange. There was rapid clinical improvement after the whole-blood exchange transfusion. The patient's subsequent clinical course was marked by a disappearance of the parasitemia and continued slow, general improvement. Therapy with clindamycin was continued for 14 days after the exchange transfusion and quinine for 17 days. CONCLUSION: In cases of severe babesiosis, prompt institution of whole-blood exchange transfusion, in combination with appropriate antimicrobial therapy, can be life-saving.

PMID: 10738042 [PubMed - indexed for MEDLINE]

28. J Am Anim Hosp Assoc. 1999 Mar-Apr;35(2):125-8.

Babesia gibsoni infections in dogs from North Carolina.

Birkenheuer AJ, Levy MG, Savary KC, Gager RB, Breitschwerdt EB.

Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA.

The recognition of canine babesiosis in North Carolina caused by Babesia gibsoni documents the expansion of the previously reported endemic area of this disease. Clinical signs ranged from severe hemolytic anemia and thrombocytopenia to subclinical infections. No infected dogs had traveled to endemic areas. Antibabesial treatment failed to eradicate the organism from infected dogs.

PMID: 10102180 [PubMed - indexed for MEDLINE]

29. Ann Trop Med Parasitol. 1998 Jun;92(4):513-9.

Parasite localization and dissemination in the Babesia-infected host.

Schetters TP, Kleuskens J, Scholtes N, Gorenflot A.

Parasitology R & D Department, Intervet Int. b.v., Boxmeer, The Netherlands. parasitology@intervet.akzonobel.nl

Babesia bovis infections in cattle and B. canis infections in dogs are characterized by non-haemolytic anaemia and low parasitaemia during the acute phase of the disease. In this phase of the disease, animals suffer from hypotension followed by disturbances of the coagulation system. This review discusses the hypothesis that may explain the process of parasite localization in the host, and the consequences of such localization. It is suggested that hypotension favours the interaction between infected erythrocytes and the endothelial lining, thus facilitating localization of the infection. In addition, activation of the coagulation system by a parasite-derived molecule (one associated with the surface of infected erythrocytes or a soluble antigen) might consolidate this situation by causing cellular plugs to form. The continued proliferation of parasites in such plugs may then result in the occurrence of capillaries that are particularly heavily parasitised. An explanation is also suggested for the protective effect of vaccines against clinical babesiosis, based on the soluble parasite antigens that are released into the medium in cultures of babesial parasites.

PMID: 9683902 [PubMed - indexed for MEDLINE]

30. J Clin Apher. 1998;13(1):32-6.

Therapeutic apheresis for babesiosis.

Evenson DA, Perry E, Kloster B, Hurley R, Stroncek DF.

Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, USA.

Infection with the tick-borne protozoa Babesia is becoming more common. Babesiosis is usually successfully treated with antibiotics but, in some cases, apheresis may also be indicated. We report two patients with babesiosis and hemolysis treated by apheresis and antibiotics. One case had traditional indications for red blood cell (RBC) exchange, and a second patient was treated with RBC exchange, and plasmapheresis for hemolysis, probably secondary to Babesia parasitemia. Case 1 involved a 44-year-old man with chronic relapsing pancreatitis who had become infected with Babesia from a unit of RBCs transfused during surgery. At 5 weeks after surgery, fever and severe hemolysis developed, along with a hemoglobin of 69 g/L; 30% of his RBCs were found to be infected with Babesia. This patient had several postoperative complications; the babesiosis was treated with clindamycin, quinine, and three RBC exchanges. Parasitemia fell to less then 1% of RBCs, but the patient died of pancreatitis. Case 2 was a 47-year-old man with a renal transplant who had been receiving immunosuppressive therapy for 8 years. He had a history of tick bites, fever, and hemolytic anemia. Analysis of a peripheral blood smear detected Babesia. He was initially treated with antibiotic therapy and two RBC exchanges. Hemolysis improved transiently but worsening parasitemia developed later, as well as an IgG RBC autoantibody. He was then treated by plasmapheresis and RBC exchange. Although his condition improved, he had a third hemolytic episode, which was treated with plasmapheresis and RBC exchange before the parasitemia and autoimmune hemolytic anemia disappeared. In conclusion, immunosuppressed or severely ill people who become infected with Babesia may benefit from RBC exchange or plasmapheresis, or both.

PMID: 9590496 [PubMed - indexed for MEDLINE]

31. Vet Parasitol. 1997 Apr;69(1-2):1-8.

Equine babesiosis associated with strenuous exercise: clinical and pathological studies in Jordan.

Hailat NQ, Lafi SQ, al-Darraji AM, al-Ani FK.

Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid, Jordan.

Clinical, haematological and pathological studies were undertaken in Jordan in a stud of 103 racing horses clinically suffering from babesiosis and apparently healthy animals. Out of 47 horses which participated in strenuous exercise, three mares showed sudden onset of immobility and reluctance to move and two mares died. Clinical examination revealed that these five horses (group 1) had fever, anorexia, weakness and severe icterus and, in two mares, haemoglobinuria. Haematological examination revealed that all five horses were heavily parasitized with Babesia equi. This was also found in four horses (group 2) with no evidence of clinical babesiosis. In group 3 (94 horses), neither clinical signs nor B. equi were observed in the blood. The horses in group 1 and 2 recovered after treatment with imidocarb. When the mean values of white blood cell count, red blood cell count, haemoglobin and packed cell volume in group 1 were compared with those for groups 2 and 3, a significant difference was found (P < 0.05). A significant difference was also found when the mean values were compared before and after treatment. Examination of serum total protein, bilirubin and serum enzymes revealed a significant decrease in the mean value of total serum protein (P < 0.05), and a significant increase in the mean values of bilirubin (P < 0.05) in group 1 compared to groups 2 and 3. A significant elevation in the mean value of aspartate aminotransaminase, gamma-glutamyltransferase and creatine phosphokinase and a substantial elevation in the mean value of alkaline phosphatase was also observed in group 1 compared to groups 2 and 3. Postmortem examination of the dead horses showed that the animals had icterus, hepatomegaly and full urinary bladder with deep-red urine. Histopathological examination of the liver showed massive centrilobular degeneration and necrosis. The bile canaliculi and bile ducts were prominent and plugged with dark-brown to canary-coloured bile pigments. The lungs had congestion, oedema, and thrombosis of pulmonary veins. Our results suggest that the horses suffered from B. equal with clinical manifestation following exercise. The clinical, haematological and pathological findings indicate that the animals suffered from haemolytic anaemia which responded to imidocarb therapy.

PMID: 9187024 [PubMed - indexed for MEDLINE]

32. Braz J Infect Dis. 1997 Mar;1(1):17-26.

Emerging Pathogens Associated with Tick-Borne Infections.

Roberts R, Soave R.

Department of Medicine, The New York Hospital-Cornell Medical Center.

In recent years, several microbial agents have been identified that result in significant morbidity and mortality. The newly recognized tick borne infections, babesiosis and ehrlichiosis, may be transmitted by the same tick that transmits Borrelia burgdorferi and simultaneous infections may occur. Babesia are intraerythrocytic protozoa that may cause severe hemolytic anemia, whereas Ehrlichia, depending on the species, may infect either monocytes or granulocytes, with associated leukopenia, thrombocytopenia and anemia. Improved laboratory surveillance is urgently needed to assess the prevalence of these worldwide pathogens in order to institute appropriate infection control efforts.

PMID: 11107234 [PubMed - as supplied by publisher]

33. Vet Rec. 1996 Oct 5;139(14):344-5.

Babesiosis in a six-day-old calf.

Egeli AK.

Department of Sheep and Goat Research, Sandnes, Norway.

Babesiosis was diagnosed in a six-day-old calf born indoors to a heifer which had been on a tick-infested pasture until 14 days before calving. The calf had typical symptoms of haemolytic anaemia and died after three days despite a blood transfusion. The erythrocytes in a blood smear made on the day it became ill were heavily infected with Babesia divergens and the lesions observed post mortem were similar to those described in babesiosis in adult cattle.

PMID: 8903013 [PubMed - indexed for MEDLINE]

34. J Parasitol. 1996 Oct;82(5):728-32.

Experimental Babesia microti infection in golden hamsters: immunoglobulin G response and recovery from severe hemolytic anemia.

Hu R, Yeh MT, Hyland KE, Mather TN.

Center for Vector-Bome Disease, University of Rhode Island, Kingston 02881, USA.

We described the parasitemia, hematologic changes, and immunity developed by golden hamsters during 8 wk of infection with Babesia microti following experimental inoculation. All 8 hamsters used in this study were readily infected. Animals attained peak parasitemias asynchronously but within a 2-wk period. Most of the animals reached their peak parasitemia by 4 wk postinoculation, attaining a mean +/- SD of 21.9 +/- 9.4% infected erythrocytes (range = 20-35%). Red blood cell count, packed cell volume, and hemoglobin level were used to monitor the course of the hemolytic anemia experienced by infected hamsters. All 3 measures corresponded inversely to the parasitemia; significant hematologic changes (P = 0.0001) were observed during the 8 wk of monitoring. Although all hamsters suffered from severe hemolytic anemia, they also recovered within the same period. Golden hamsters developed a detectable anti-B. microti IgG response by 2 wk postinoculation. Individual animals typically attained peak antibody levels (> or = 1:8, 192) 1 wk after the peak parasitemia. Hamsters retained a high IgG titer (> or = 1:4,096), although parasitemias fell dramatically, fluctuating thereafter at low levels (< 5%).

PMID: 8885880 [PubMed - indexed for MEDLINE]

35. Exp Parasitol. 1995 Dec;81(4):512-8.

Use of the Bo-RBC-SCID mouse model for isolation of a Babesia parasite from grazing calves in Japan.

Tsuji M, Terada Y, Arai S, Okada H, Ishihara C.

Department of Veterinary Medicine, Rakuno-gakuen University, Ebetsu, Japan.

SCID mice with circulating bovine red blood cells (Bo-RBC-SCID mice) were used to isolate Babesia parasites from grazing calves in Japan. Although the initial blood samples obtained from the calves contained both Babesia and Theileria parasites, we were able to isolate only the Babesia parasites by repeated blood passages in Bo-RBC-SCID mice, taking advantage of the much more rapid growth of Babesia than of Theileria. The parasites isolated had characteristics of large-type Babesia, showing typical paired pyriform morphology. The Bo-RBC-SCID mice infected with the Babesia parasites developed a high level of parasitemia, showing severe clinical symptoms characterized by hemoglobinuria, jaundice, and hemolytic anemia. In addition, some mice exhibited nervous symptoms, particularly paralysis of both posterior limbs. The results demonstrated that the Bo-RBC-SCID mouse model was useful not only for isolating Babesia from cattle but also for studying the disease caused by the Babesia infection.

PMID: 8542992 [PubMed - indexed for MEDLINE]

36. J Vet Med Sci. 1994 Jun;56(3):611-2.

Changes of serum hemolytic activity and the number of reticulocytes in canine Babesia gibsoni-infection.

Onishi T, Suzuki S.

University of Osaka Prefecture, College of Agriculture, Department of Veterinary Internal Medicine, Japan.

When the serum hemolytic activity in Babesia gibsoni-infected dogs was determined with self red blood cells from the infected animals, the decrease in the activity is paralleled with the increase in the number of reticulocytes. The activity determined with red blood cells from phenylhydrazine-induced anemia also decreased parallel with the increase in the number of reticulocytes. These results suggest that the rapid decrease in the serum hemolytic activity after reaching the peak is due to the increase in reticulocytes, which are probably unsusceptible to the hemolytic factor(s).

PMID: 7948407 [PubMed - indexed for MEDLINE]

37. J Vet Med Sci. 1993 Apr;55(2):203-6.

Serum hemolytic activity of Babesia gibsoni-infected dogs: the difference in the activity between self and nonself red blood cells.

Onishi T, Suzuki S, Horie M, Hashimoto M, Kajikawa T, Ohishi I, Ejima H.

Department of Veterinary Science, College of Agriculture, University of Osaka Prefecture, Japan.

The serum hemolytic activity of Babesia gibsoni-infected dogs varied when assayed with nonself red blood cells from different dogs, whereas it did not vary when assayed with red blood cells, irrespective of self or nonself, from a particular dog throughout the experiment. The variety in activity determined with nonself red blood cells was not related to the type of red blood cell by DEA, D and J systems. Serum hemolytic activity with self red blood cells was different in the course of infection from that with nonself red blood cells, especially in the late stage of infection, when the activity with self red blood cells decreased more rapidly than that with nonself red blood cells. The results indicate that the serum hemolytic activity of B. gibsoni-infected dogs determined with self red blood cells probably reflects the in vivo activity, suggesting that the rapid decrease in activity in the late stage of infection is a way of acquired resistances for the host to recover from hemolytic anemia in the infection. The facts that the hemolytic activity increased by heating the serum at 56 degrees C, that the osmotic fragility of red blood cells remained almost on the same during the course of infection and that Coombs' test for red blood cells of the infected animal was negative suggest that the immune-mediated hemolytic anemia is not a possible mechanism for the progressive and severe anemia in B. gibsoni-infection. The present results support the previous notion that the increased serum hemolytic activity is at least one of the causes of anemia in canine B. gibsoni-infection.

PMID: 8512998 [PubMed - indexed for MEDLINE]

38. Scand J Infect Dis. 1992;24(4):541-7.

First documented case of human babesiosis in Sweden.

Uhnoo I, Cars O, Christensson D, Nyström-Rosander C.

Department of Infectious Diseases, University Hospital, Uppsala, Sweden.

A 34-year-old splenectomized man presented with fever, myalgia and dysuria. His condition rapidly deteriorated, he became anuric and developed severe haemolytic anaemia, thrombocytopenia and fibrinolysis. Peripheral blood smears revealed intra-erythrocytic parasites consistent with Babesia divergens in 40% of the erythrocytes. The diagnosis was confirmed by gerbil inoculation and by a significant rise in antibody titer. Blood exchange transfusion reduced the number of babesia infected erythrocytes to 1%. Parenteral therapy with a combination of quinine and clindamycin eradicated parasitaemia after 10 days of treatment and the patient rapidly improved. Renal failure necessitated haemodialysis for one month, whereafter the patient made a full recovery. Human babesiosis is a rare disease, but with a potential fatal outcome and should be considered as a diagnostic alternative in splenectomized and otherwise immunocompromised individuals with severe febrile illnesses.

PMID: 1411322 [PubMed - indexed for MEDLINE]

39. J Am Vet Med Assoc. 1991 Sep 1;199(5):601-5.

Hemolytic anemia caused by Babesia gibsoni infection in dogs.

Conrad P, Thomford J, Yamane I, Whiting J, Bosma L, Uno T, Holshuh HJ, Shelly S.

Department of Veterinary Microbiology and Immunology, University of California, Davis 95616.

Babesia gibsoni caused severe hemolytic anemia in 11 dogs from southern California. The most common clinical signs of B gibsoni infection were lethargy, anorexia, anemia, and thrombocytopenia. Acute infection with B gibsoni may be misdiagnosed as autoimmune hemolytic anemia. Diagnosis was most reliably determined by identification of the intraerythrocytic parasites on Giemsa-stained blood smears. The pathogenicity of B gibsoni, difficulties in diagnosis, the parasite's resistance to treatment with available drugs, and frequent interstate movement of dogs indicate that this disease may be a serious threat to dogs throughout the United States.

PMID: 1787120 [PubMed - indexed for MEDLINE]

40. Aust Vet J. 1991 Jun;68(6):204-9.

Clinical and pathological findings of Babesia infection in dogs.

Irwin PJ, Hutchinson GW.

Graduate School of Tropical Veterinary Science and Agriculture, James Cook University of North Queensland, Townsville.

The clinical and pathological findings of Babesia infection in 32 dogs in northern Australia are presented. Eleven different breed types were represented from 6 localities in north Queensland and one locality in northern Western Australia. Twenty three (72%) were males. Babesia-infected dogs were grouped by the degree of haematological disturbance and clinical severity: Acute babesiosis (25/32), all pups with severe haemolytic anaemia; subclinical carriers (5/32) with non-specific malaise, characterised haematologically by a normal erythrogram but marked leucopenia; chronic anaemia, observed in 2 adult dogs. Pups were azotaemic (serum urea greater than 6.6 mmol/l) and had elevated serum bilirubin levels (20.8 to 48.5 mmol/l). Total serum protein was usually within the normal range. Pups that died were also hypoglycaemic and severely hyperkalaemic (K+ greater than 10 mmol/l). Low parasitaemias in routine blood smears complicated diagnosis but smears made from ear or toe capillaries, or after haematocrit concentration, greatly enhanced finding parasitised cells. At necropsy, pallor and jaundice were the most consistent observations. Haemoglobinuric nephrosis, an active reticulo-endothelial system and capillaries packed with large numbers of infected erythrocytes were the main histopathological findings. A combination of imidocarb dipropionate at 5 mg/kg body weight, given intramuscularly, with fluid therapy and blood transfusion was the most successful treatment.

PMID: 1888313 [PubMed - indexed for MEDLINE]

41. J Parasitol. 1990 Aug;76(4):564-7.

Serum hemolytic activity in dogs infected with Babesia gibsoni.

Onishi T, Ueda K, Horie M, Kajikawa T, Ohishi I.

College of Agriculture, University of Osaka Prefecture, Japan.

The hemolytic activity in serum of Babesia gibsoni-infected dogs was examined. When the activity was assayed in a reaction system consisting of similar concentrations of the serum and canine red blood cells to those in blood, significant hemolysis was observed. The activity of the serum of B. gibsoni-infected dogs, either naturally or experimentally, was always higher than that of uninfected animals. Moreover, in the experimental infection with B. gibsoni, the change in serum hemolytic activity was parallel to those of anemia and parasitemia, whereas it was inversely parallel to that of the hematocrit value. The present study revealed the presence of a hemolytic factor(s) in the serum of B. gibsoni-infected dogs, suggesting that the progressive anemia was due to hemolysis by the factor(s).

PMID: 2380866 [PubMed - indexed for MEDLINE]

42. Conn Med. 1990 Aug;54(8):425-7.

Babesiosis in a Connecticut resident.

Alward W, Javaid M, Garner J.

Department of Medicine, New Britain General Hospital, CT 06050.

Fewer than 200 confirmed cases of babesiosis have been reported in the last decade. Most cases in the United States have occurred on Cape Cod, Nantucket Island, and Long Island. Babesia microti, a malaria-like protozoan that parasitizes erythrocytes, is responsible for this illness in the United States. Infection is often subclinical but may be fulminant, especially in infants, the elderly, and in asplenic patients. Symptoms are nonspecific, usually consisting of fever and myalgias. Common laboratory abnormalities include evidence of hemolysis and thrombocytopenia. We report a case of babesiosis in an elderly male manifested by high fevers, confusion, hemolytic anemia, and thrombocytopenia.

PMID: 2225809 [PubMed - indexed for MEDLINE]

43. Nippon Juigaku Zasshi. 1990 Apr;52(2):321-7.

Increased erythrophagocytic activity of macrophages in dogs with Babesia gibsoni infection.

Murase T, Maede Y.

Department of Veterinary Internal Medicine, Hokkaido University, Sapporo, Japan.

To elucidate the mechanism of anemia caused by Babesia gibsoni infection in dogs, the erythrophagocytic activity of macrophages in infected dogs was investigated in vitro. In the present study, macrophages obtained from peripheral blood (PB-macrophages) and bone marrow (BM-macrophages) of splenectomized dogs with chronic B. gibsoni infection were examined. The BM-macrophages in the splenectomized dogs with chronic babesiosis exhibited an increased erythrophagocytic activity compared with those from splenectomized, non-infected dogs. In the infected dogs, erythrophagocytic activities of macrophages against both auto- and iso-erythorcytes from normal dogs were almost the same. Administration of an anti-protozoal drug, diminazene diaceturate, resulted in a decrease of the erythrophagocytic activity of BM-macrophages associated with an increase of the hematocrit value in splenectomized dogs with chronic babesiosis. In splenectomized dogs with acute babesiosis, erythrophagocytic activity of BM-macrophages was also elevated. Such a phenomenon was not, however, observed in splenectomized dogs with onion-induced hemolytic anemia. These results suggest that the erythrophagocytic ability of macrophages in the infected dogs might be accelerated by parasites per se through an unknown mechanism, resulting in severe anemia in spite of low parasitemia.

PMID: 2348598 [PubMed - indexed for MEDLINE]

44. Vet Clin North Am Small Anim Pract. 1987 Nov;17(6):1443-61.

Erythrocytic rickettsia and protozoa of the dog and cat.

MacWilliams PS.

Department of Pathobiological Sciences, University of Wisconsin-Madison School of Veterinary Medicine.

This article summarizes the biologic and clinical features of the rickettsia and protozoa of canine and feline erythrocytes that are significant in North America: Haemobartonella canis, Haemobartonella felis, Cytauxzoon felis, Babesia canis, and Babesia gibsoni.

PMID: 3328397 [PubMed - indexed for MEDLINE]

45. J Wildl Dis. 1985 Apr;21(2):149-52.

Babesia odocoilei Emerson and Wright, 1970 in white-tailed deer, Odocoileus virginianus (Zimmermann), in Virginia.

Perry BD, Nichols DK, Cullom ES.

Pooled blood samples from six white-tailed deer from the Great Dismal Swamp in Virginia were inoculated into two splenectomized deer. A moderately severe clinical reaction ensued, characterized by a hemolytic anemia, and a Babesia found in both recipient animals was presumptively identified as B. odocoilei. This is the first reported identification of this parasite in white-tailed deer in Virginia.

PMID: 3999247 [PubMed - indexed for MEDLINE]

46. Am J Vet Res. 1985 Jan;46(1):256-62.

Experimental babesiosis in coyotes and coydogs.

Roher DP, Anderson JF, Nielsen SW.

One splenectomized and 6 intact coyotes (Canis latrans), and 2 coydogs were experimentally inoculated with a recent isolate of Babesia gibsoni. The disease was mild in intact animals, was fatal in the splenectomized coyote, and was characterized by a regenerative hemolytic anemia with the PCV decreasing to 16% in intact animals and to 6% in the splenectomized coyote. Peak parasitemia ranged from 3% to 21% of erythrocytes infected and was inversely correlated to PCV. Serum lactate dehydrogenase, bilirubin, and globulin concentrations were increased in all infected animals. Three weeks after inoculation, specific antibody titers increased to 1:65,536 and remained elevated in the chronically infected animals. The splenectomized coyote had progressive weakness until death, 24 days after inoculation. Intact animals had splenomegaly and anorexia at the height of infection. The splenectomized coyote had generalized edema, omental petechiae, renal and hepatic degeneration, membrano-proliferative glomerulonephritis and congestion, extramedullary hematopoiesis, lymphoid hyperplasia, and severe hemosiderosis in an accessory spleen. The only consistent change in the intact animals was splenomegaly.

PMID: 3970435 [PubMed - indexed for MEDLINE]

47. Am J Med. 1984 Apr;76(4):696-701.

Babesiosis in splenectomized adults. Review of 22 reported cases.

Rosner F, Zarrabi MH, Benach JL, Habicht GS.

Since 1957, there have been 22 reported cases of human babesiosis in splenectomized persons, representing about one third of all clinical human babesiosis. Splenectomy had been performed one month to 36 years (mean 8.7 years, median 6.0 years) earlier for a variety of reasons. Four of the seven European cases were from Babesia divergens whereas 12 of the 15 United States cases were from B. microti. Most of the 22 patients had moderate to severe clinical disease including hemolytic anemia, yet all but six recovered. Three patients had transfusion-acquired babesiosis. Treatments employed included the use of chloroquine, quinine, pyrimethamine, pentamidine, clindamycin, dialysis, and exchange transfusion. Splenectomized and/or otherwise immunocompromised hosts should be advised to avoid visiting endemic areas for babesiosis such as Nantucket Island or Martha's Vineyard in Massachusetts and Shelter Island and other parts of Long Island, New York. Babesiosis must be considered as one of the not uncommon organisms responsible for the postsplenectomy sepsis syndrome and one for which there is no current prophylaxis.

PMID: 6424470 [PubMed - indexed for MEDLINE]

48. Contemp Top Immunobiol. 1984;12:463-90.

Cellular immunity to malaria and babesia parasites: a personal viewpoint.

Allison AC.

PMID: 6365445 [PubMed - indexed for MEDLINE]

49. Am J Ophthalmol. 1982 Mar;93(3):307-11.

Ocular findings in human babesiosis (Nantucket fever).

Ortiz JM, Eagle RC Jr.

Human babesiosis (Nantucket fever) is a rare, tick-borne intraerythrocytic parasitic disease characterized by fever, lymphadenopathy, arthralgias, and hemolytic anemia. A 34-year-old woman, who had previously undergone surgical removal of her spleen, was hospitalized because of presumed hepatitis. The many retinal nerve fiber layer infarcts and serologic abnormalities suggested collagen disease. The diagnosis of babesiosis was established by the demonstration of intraerythrocytic parasites and a greatly elevated titer to Babesia microti. The infection was treated with chloroquine, orally administered quinine, and pyramethamine, and her symptoms resolved within one month. The retinopathy was probably the result of focal vasculitis secondary to immune complex disease caused by chronic infection.

PMID: 7200325 [PubMed - indexed for MEDLINE]

50. Am J Trop Med Hyg. 1981 Mar;30(2):304-7.

Experimental Babesia microti infections in Macaca mulatta: recurrent parasitemia before and after splenectomy.

Ruebush TK 2nd, Collins WE, Warren M.

To learn more about the course of Babesia microti infections in primates, six Macaca mulatta monkeys with blood-induced B. microti infections were followed for 270 days with regular thick blood smears. Three of the monkeys experienced from 1--3 recurrences of parasitemia defined here as greater than or equal to 200 organisms/mm3 blood. Following splenectomy on day 297, parasitemia recurred in all animals, reaching levels of 1.9 x 10(5) to 2.7 x 10(6) organisms/mm3, and was associated with a moderately severe hemolytic anemia. These findings suggest that similar recurrences of parasitemia may occur in human cases, and that splenectomy may present a risk to persons with a past history of B. microti infection.

PMID: 7235122 [PubMed - indexed for MEDLINE]

51. Transfusion. 1981 Mar-Apr;21(2):193-8.

Red cell exchange: treatment of babesiosis in a splenectomized patient.

Cahill KM, Benach JL, Reich LM, Bilmes E, Zins JH, Siegel FP, Hochweis S.

A splenectomized woman with a history of hepatic disorders was diagnosed as having babesiosis. The patient was unsuccessfully treated with chloroquine and with pentamidine isothionate. A parasitemia of 15 per cent was reduced permanently to less than 1 per cent after a red blood cell exchange, but a low grade parasitemia still existed 10 months after onset. On two separate occasions, the patient was found to have selective IgA deficiency, a reduction of T lymphocytes, and a reduction in function of both T and B lymphocytes. This case represents the highest and the longest duration of parasitemia ever recorded. It reports the first use of pentamidine and red blood cell exchange transfusion in human babesiosis, one of the earliest diagnosed cases of babesiosis, and the most severe clinical case to survive.

PMID: 7194528 [PubMed - indexed for MEDLINE]

52. Exp Parasitol. 1981 Feb;51(1):116-23.

Babesia microti: biochemistry and function of hamster erythrocytes infected from a human source.

Roth EF Jr, Tanowitz H, Wittner M, Ueda Y, Hsieh HS, Neumann G, Nagel RL.

PMID: 7461085 [PubMed - indexed for MEDLINE]

53. J Parasitol. 1977 Jun;63(3):464-70.

Experimental infection with Plasmodium chabaudi in rats. Observations on adaptation and the immune responses to infection.

Musoke AJ, Cox HW.

Plasmodium chabaudi was adapted to rats after some initial refractoriness. Progressive adaptation was indicated by shortening of the prepatent period and increases in peak parasitemia with successive passages. Rats infected with parasites of early passages resisted the infection, and even splenectomized rats quickly recovered. However, the parasites appeared to become more virulent with successive passages and after the 45th passage, all adult rats inoculated with the parasite died with severe hemolytic anemia. After adaptation, infections of the rat strain appeared to stimulate resistance in mice that was more effective against challenge with parasites of the homologous strain than it was against challenge with mouse strain parasites. Rats recovered from P. chabaudi were highly resistant to the homologous strain of P. chabaudi, but they were no more resistant to Babesia radhaini than were normal rats. However, when the rat strain was used to immunize mice, they were as resistant to B. rodhaini as they were to mouse strain P. chabaudi. Serologic studies made on rats with acute infection indicated that anemia was associated with antibody to erythrocytes as well as with high parasitemia. The soluble serum antigen (SA) associated with malarial and babesial infections was not present and its antibody was not detected in serum of recovered rats. However, antibody to SA was detected in blood mice that had recovered from rat strain P. chabaudi infection. Thus acquired resistance to B. rodhaini appeared to have been associated with elaboration of SA.

PMID: 864563 [PubMed - indexed for MEDLINE]

54. Ann Intern Med. 1977 Jan;86(1):6-9.

Human babesiosis on Nantucket Island. Clinical features.

Reubush TK 2nd, Cassaday PB, Marsh HJ, Lisker SA, Voorhees DB, Mahoney EB, Healy GR.

Between 20 July and 15 Octoboer 1975, five cases of human infection with Babesia microti were diagnosed on Nantucket Island, Massachusetts. The illness was characterized by fever, drenching sweats, shaking chills, myalgia, arthralgia, extreme fatigue, and a mild-to-moderate hemolytic anemia. None of the patients had a history of splenetomy. Although all patients responded symptomatically to treatment with oral chloroquine phosphate, parasitemia and fatigue frequently persisted for several weeks to months.

PMID: 556920 [PubMed - indexed for MEDLINE]

55. Aust Vet J. 1976 Oct;52(10):451-4.

Vaccination with Babesia argentina in 5 beef herds in south-eastern Queensland.

Emmerson FR, Knott SG, Callow LL.

Observations on the use of a vaccine containing Babesia argentina in 5 partly susceptible beef herds in south-eastern Queensland were made on 1,029 female breeding cattle over a period of 4 years. Groups averaging about 20 heifers were given 0, 1, 2 or 3 vaccinations. Incidence derived from groups experiencing clinical attacks were 17.9% for unvaccinated cattle and 1.2% for vaccinates. Increasing the number of vaccinations did not appear to increase protection. The one clinical manifestation of infection with B. bigemina was associated with a concurrent reaction to vaccination with Anaplasma centrale. There were no cases of haemolytic anaemia in new-born calves. No severe reactions followed primary vaccination, but 2 revaccinated animals became sick.

PMID: 1016135 [PubMed - indexed for MEDLINE]

56. Z Parasitenkd. 1976 Aug 16;50(2):103-8.

Babesia hylomysci in mice: Preference for erythrocytes of a particular age-group and pathogenesis of the anaemia.

Hussein HS.

Scintillation counting on 59Fe-labelled haemoglobin in erythrocytes, serum and urine during B. hylomysci infection in mice demonstrated that the parasite had a predilection to older mature erythrocytes and that the anaemia produced during the infection was mainly due to the direct destruction of infected erythrocytes. An autoimmune reaction has also been incriminated as a factor in the pathogenesis of the anaemia, but was of a lesser magnitude and its manifestations were masked by the direct destruction of infected erythrocytes.

PMID: 961007 [PubMed - indexed for MEDLINE]

57. Am J Vet Res. 1975 Jun;36(6):843-5.

Recurring hemolytic anemia, babesiasis, and influenza A viruses in a yak at low altitude in Nepal.

Graves IL, Adams WH, Pyakural S.

Episodes of hemolysis and leukocytosis which were associated with Babesia bigemina followed each of 3 challenge exposures to influenza A viruses. It is possible that viral infection altered the immunologic host-parasite equilibrium. Acute thrombocytopenia and rouleaux formation were also observed. Death, attributed to liver flukes, occurred 168 days after the yak was transferred from high to low altitude. A 2nd yak died of foot-and-mouth disease, thus supporting the Nepali belief that yaks will not survive at the lower altitudes of Kathmandu.

PMID: 125056 [PubMed - indexed for MEDLINE]

58. Am J Trop Med Hyg. 1975 May;24(3):423-30.

Pathogenesis of acute avian malaria. III. Antigen and antibody complexes as a mediator of anemia in acute Plasmodium gallinaceum infections of chickens.

Soni JL, Cox HW.

In a study of antigens and antibodies found in malarious chicken blood, antigen activity was found in plasma, and in hypertonic saline eluates of blood cells. A soluble antigen was extracted from parasites liberated from erythrocytes. Two classes of antigen were differentiated, one a globulin associated "serum antigen" which was found to show identity with a serum antigen from blood of rats with acute Babesia rodhaini infection, and another that was associated with the Plasmodium gallinaceum parasite. The plasma also contained antibody to both classes of antigen. Study of blood cells from normal chickens made anemic by injections of autohemagglutinin-free malarious plasma indicated that both serum antigen and its antibody were present in eluates of the washed blood cells. Direct immunofluorescent tests of these cells with conjugated antibody to serum antigen, and with conjugated antibody to P. gallinaceum parasite antigen showed that they reacted with the antibody to serum antigen but gave no reaction with antibody to parasite antigen. From this information it is suggested that soluble complexes of serum antigen and its antibody combined with the erythrocytes, and that these complexes acted as opsonin to cause the cells to be sequestered and destroyed in the spleen, or may have fixed complement to cause intravascular hemolysis. The serologic identity of serum antigen from malarious chickens and from rats with babesiosis, and its distinction from parasite antigen, led to the speculation that it might be an autoantigenic macroglobulin.

PMID: 125550 [PubMed - indexed for MEDLINE]

59. Am J Clin Pathol. 1974 Nov;62(5):612-8.

Babesiosis in man. Sixth documented case.

Anderson AE, Cassaday PB, Healy GR.

PMID: 4412160 [PubMed - indexed for MEDLINE]

60. Ann Trop Med Parasitol. 1972 Mar;66(1):1-5.

Protective effect of haemolytic serum on mice infected with Babesia rodhaini.

McHardy N.

PMID: 5021569 [PubMed - indexed for MEDLINE]