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| | __NOTOC__ |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| {{DiseaseDisorder infobox |
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| Name = {{PAGENAME}} |
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| Image = Babiesa spp.jpg |
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| Caption = |
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| ICD10 = {{ICD10|B|60|0|b|50}} |
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| ICD9 = {{ICD9|088.82}} |
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| ICDO = |
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| OMIM = |
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| DiseasesDB = 1200 |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| MeshID = D001404 |
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| }}
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| {{Babesiosis}} | | {{Babesiosis}} |
| {{CMG}} | | {{About1|Babesia microti}} |
| | {{SK}} Babesia microti, Texas cattle fever, Redwater, or Piroplasmosis |
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| | {{CMG}} {{AE}} {{IMD}} |
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| ==[[Babesiosis overview|Overview]]== | | ==[[Babesiosis overview|Overview]]== |
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| ==[[Babesiosis historical perspective|Historical Perspective]]== | | ==[[Babesiosis historical perspective|Historical Perspective]]== |
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| ==[[Babesiosis pathophysiology|Pathophysiology]]== | | ==[[Babesiosis pathophysiology|Pathophysiology]]== |
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| ==[[Babesiosis epidemiology and demographics|Epidemiology & Demographics]]==
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| ==[[Babesiosis risk factors|Risk Factors]]==
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| ==[[Babesiosis screening|Screening]]==
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| ==[[Babesiosis causes|Causes]]== | | ==[[Babesiosis causes|Causes]]== |
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| ==[[Babesiosis differential diagnosis|Differentiating Babesiosis]]==
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| ==[[Babesiosis natural history|Complications & Prognosis]]== | | ==[[Babesiosis differential diagnosis|Differentiating Babesiosis from other Diseases]]== |
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| ==Diagnosis== | | ==[[Babesiosis epidemiology and demographics|Epidemiology and Demographics]]== |
| [[Babesiosis history and symptoms|History and Symptoms]] | [[Babesiosis physical examination|Physical Examination]] | [[Babesiosis laboratory tests|Laboratory tests]] | [[Babesiosis electrocardiogram|Electrocardiogram]] | [[Babesiosis x ray|X Rays]] | [[Babesiosis CT|CT]] | [[Babesiosis MRI|MRI]] [[Babesiosis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Babesiosis other imaging findings|Other images]] | [[Babesiosis other diagnostic studies|Alternative diagnostics]] | |
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| ==Treatment==
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| [[Babesiosis medical therapy|Medical therapy]] | [[Babesiosis surgery|Surgical options]] | [[Babesiosis primary prevention|Primary prevention]] | [[Babesiosis secondary prevention|Secondary prevention]] | [[Babesiosis cost-effectiveness of therapy|Financial costs]] | [[Babesiosis future or investigational therapies|Future therapies]]
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| ==Epidemiology== | | ==[[Babesiosis risk factors|Risk Factors]]== |
| Babesiosis is a [[Vector (biology)|vector]]-borne illness usually transmitted by [[tick]]s. (''Babesia microti'' uses the same tick vector, ''[[Ixodes scapularis]]'', as [[Lyme disease]] does, and frequently occurs in conjunction with it.) In ''babesia''-endemic areas, the organism can also be transmitted by [[blood transfusion]]. The disease exists mostly in Eastern Long-Island and its barrier island, Fire Island, and the islands off the coast of Massachusetts. It is sometimes called "The Malaria of The North East."
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| Babesiosis causes a disease very similar to Malaria. In mild cases, people may experience mild fevers and anemia. In more severe cases, fevers go up to 105 degrees with shaking chills, and anemia (hemolytic anemia) can become severe. Organ failure may follow including adult respiratory distress syndrome.
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| Infection with ''Babesia'' parasites can be asymptomatic or cause a mild non-specific illness, and therefore many cases go unnoticed. It may also cause severe disease. While most severe cases occur in the very young, very old, or persons with underlying medical conditions (such as [[immunodeficiency]]) and those without a spleen, they can occur in normal individuals. Indeed, both the incidence or all cases of babesiosis and severe cases are increasing rapidly. Some cases are identified when patients with another tick-borne illness are screened for babesiosis.
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| Little is known about the occurrence of ''Babesia'' species in malaria-[[Endemic (epidemiology)|endemic]] areas, where ''Babesia'' can easily be misdiagnosed as ''[[Plasmodium]]''.
| | ==[[Babesiosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ==Pathophysiology==
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| ''Babesia'' parasites reproduce in [[red blood cell]]s, where they can be seen as cross-shaped inclusions (4 [[merozoite]]s asexually budding but attached together forming a structure looking like a "Maltese Cross") and cause [[hemolytic anemia]], quite similar to [[malaria]].
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| Note that unlike the ''[[Plasmodium]]'' parasites that cause malaria, ''Babesia'' species lack an exo-erythrotic phase, so the liver is usually not affected.
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| ==Diagnosis== | | ==Diagnosis== |
| Babesiosis is easy to diagnose but only if it is suspected. It will not show up on any routine tests. It must be suspected when a persons with exposure in an endemic area develops persistent fevers and hemolytic anemia. Babesiosis can be diagnosed by direct examination of the blood (see photo), with [[serology]], or with [[PCR]]-based tests. Other laboratory findings include decreased numbers of [[red blood cells]] and [[platelets]] on [[complete blood count]]. | | [[Babesiosis history and symptoms|History and Symptoms]] | [[Babesiosis physical examination|Physical Examination]] | [[Babesiosis laboratory findings|Laboratory Findings]] |
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| ==Treatment== | | ==Treatment== |
| Most cases of babesiosis resolve without any specific treatment. For ill patients, treatment is usually a two-drug regimen. The traditional regimen of [[quinine]] and [[clindamycin]] is often poorly tolerated; recent evidence suggests that a regimen of [[atovaquone]] and [[azithromycin]] can be equally effective <ref name=Krause>{{cite journal | author = Krause P, Lepore T, Sikand V, Gadbaw J, Burke G, Telford S, Brassard P, Pearl D, Azlanzadeh J, Christianson D, McGrath D, Spielman A | title = Atovaquone and azithromycin for the treatment of babesiosis | journal = N Engl J Med | volume = 343 | issue = 20 | pages = 1454-8 | year = 2000 | id = PMID 11078770}}</ref>. In life-threatening cases, exchange transfusion is performed. In this procedure, the infected red blood cells are removed and replaced with fresh ones.
| | [[Babesiosis medical therapy|Medical Therapy]] | [[Babesiosis primary prevention|Prevention]] |
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| ==References== | | |
| * Herwaldt BL, Persing DH, Précigout EA, et al. A fatal case of babesiosis in Missouri: Identification of another piroplasm that infect humans. Ann Intern Med 1996;124:643-65.
| | ==Case Studies== |
| * Pershing DH, Herwaldt BL, Glaser C, et al. Infection with a Babesia-like organism in northern California. N Engl J Med 1995;332:298-303.
| | [[Babesiosis case study one|Case #1]] |
| {{reflist}}
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| {{Protozoal diseases}} | | {{Protozoal diseases}} |
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| [[Category:Parasitic diseases]] | | [[Category:Parasitic diseases]] |
| [[Category:Apicomplexa]] | | [[Category:Apicomplexa]] |
| [[Category:Infectious disease]]
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| [[Category:Mature chapter]] | | [[Category:Mature chapter]] |
| | [[Category:Disease]] |
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| [[pl:Babezjoza]] | | [[pl:Babezjoza]] |