Babesiosis
Introduction
Introduction to Babesia Babesiosis (piroplasmosis) is a parasitic disease caused by the infection of bloody protozoa in the red blood cells of Babesia through the sputum-like infection, and different species of protozoa can be used for the corresponding vertebrate. It is pathogenic, so there are various kinds of Babesia diseases such as cattle, horses, dogs, sheep and pigs. People with Babesia disease are similar to malaria in acute onset. The clinical features are intermittent heat, splenomegaly, jaundice and hemolysis. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific people Mode of transmission: parasitic spread Complications: hypotension
Cause
Cause of Babesia
Cause:
Babesia protozoa are parasitic protozoa that are parasitic in erythrocytes of vertebrate animals such as mammals and birds. They belong to the Protozoa apical complex (Apicomplexa) Sporozoasida. Piroplasmia) Babesia of Babesiidae from Piroplasmida can be divided into small and large species, usually less than 2.5m, which can cause Babesia in humans. .
Protozoa in the erythrocyte endogenous stage of vertebrates is a process of budding, which continuously ruptures red blood cells into the blood and invades other red blood cells to expand their infection. These red blood cells containing protozoa are taken by mites. After entering, as long as the red blood cells remain intact, the protozoa can develop into a sexual stage in the red blood cells to form a zygote, which continuously divides and proliferates to produce a large number of vermicules, from the ruptured intestinal epithelial cells. The bentonary worm that enters the entire corpus callosum, when entering the parotid cells, is a semi-circular pear-shaped body that is schizogony-proliferating. When the glandular protozoa infects the vertebrate with the blood-sucking infection, it can be taken from the animal. The protozoa were seen on the blood smear.
Pathogenesis
From the study of the pathological state of the affected animals, there are significant differences due to the difference between the infected animal species and the Babesia species and strains. According to electron microscopy, the merozoites of the tiny Babesia first use the front end to be close to the red blood cells. When rapidly invading red blood cells, some red blood cell membranes are brought in to make them concave and form vacuoles. When the red blood cell membrane is lysed, the vacuoles disappear, and the protozoa are distributed in the cytoplasm, eventually causing red blood cells to dissolve. Severe major disease process, a large number of red blood cells containing protozoa sometimes accumulate on small blood vessels and capillary walls, causing blood deposition and capillary occlusion, ischemia of the affected organs until tissue necrosis occurs, due to hepatic sinusoidal blood deposition It causes liver swelling, cell degeneration and even necrosis. It is most common around the central vein. It can be seen that the swollen liver and other organs are stained with bile. In the liver and spleen, phagocytic red blood cells are often seen, and hematopoietic tissue such as liver, spleen and bone marrow are proliferated. In animal Babesia, brain tissue damage is also common, death cases can be seen hemolytic anemia, spleen increased to 2 ~ 5 times, the kidney is swollen, accompanied by bleeding points.
Prevention
Babesia prevention
Avoid contact with cockroaches. Avoid entering the epidemic area during the season of media mites, and if it enters the epidemic area, repellent should be applied. Animals should be regularly smothered, including carcasses and livestock and their environment. Strengthen animal husbandry quarantine, early detection of infected animals, take effective isolation measures, and give active treatment. Eliminate the habitat and surrounding wild rodents and try to avoid contact with them. Collectives and individuals should take anti-mite measures, wear protective clothing and socks, use killing and snoring agents, thoroughly check the body for adhesion after outdoor activities, and quickly remove the sputum attached to the body.
Complication
Babesia complications Complications
Hodgkin's disease is a malignant tumor of the lymphatic network that often occurs in a group of lymph nodes and spreads to other lymph nodes and/or extranodal organs or tissues. Mediastinal mass, symptoms of tracheal and bronchial compression, anemia and other pathogens and pathogenesis are unknown. Many studies suggest that viral infections and immune abnormalities may be pathogenic factors. Common comorbidities have thrombocytopenia and bleeding tendency when there is immune thrombocytopenia.
Symptom
Babesia symptoms common symptoms jaundice high fever fatigue aversion cold irritability low fever nausea
1. The incubation period is 1 to 9 weeks.
2. Clinical type: The initial symptoms of the disease are very different. According to the severity of the disease, there may be light, medium and severe. The protozoa in chronic patients can last for several months or even years.
(1) Light type: may only have low fever or normal body temperature, slight fatigue and discomfort, mild headache, weakness and lack of appetite.
(2) medium-sized: rapid onset, high fever up to 39 ~ 40 ° C, cold and shudder, sweating, severe headache, muscle pain, and even joint pain, sometimes phobia, depression, irritability, ambition, There may be nausea and vomiting, but no meningeal irritation, mild to moderate spleen, no abnormal lymph nodes, no rash.
(3) Severe illness: clinical manifestations of the same onset at the onset, critically ill patients, hemolytic anemia develop rapidly, accompanied by jaundice, proteinuria, hematuria and renal dysfunction, etc., patients with a history of spleen removal often have serious clinical manifestations, more severe He died within 5 to 8 days after the onset of illness.
Examine
Babesia disease check
1. The reticulocyte count is high, the white blood cell count is low, the left nucleus shifts, the thrombocytopenia, the liver function test is elevated, the blood sedimentation, proteinuria and hematuria are positive, and nitrogen and hepatic anhydride are detected.
In the blood smear microscopy, a plurality of rings are found in the red blood cells, and no pigment particles are present. In the peripheral blood smear of the patient with hemolytic anemia, 1% to 10% of the red blood cells contain the protozoa.
2. 1.0 ml of the patient's blood was inoculated into the abdominal cavity of the golden hamster, and protozoal parasitic blood was produced within 12 to 14 days. After 1 month, the tail blood was collected, and the pathogen was observed.
3. Serological diagnosis can be determined by indirect fluorescent antibody test, indirect hemagglutination, capillary agglutination test or ELISA method. PCR test can quickly determine DNA within a few hours.
Diagnosis
Diagnosis and identification of Babesia
Generally, according to the history of recent bites, there is a history of contact with infected animals or infected animals in the infected areas, and the laboratory tests are positive.
1. The history of bite and other systemic symptoms are easily confused with rickettsial disease, which can be identified by detecting protozoa according to blood samples, but should not be confused with malaria parasites when identifying the protozoa detected.
2. Severe cases of hemolysis and serum bilirubin are significantly elevated, and attention should be paid to distinguishing from other diseases with jaundice and viral hepatitis.
