Babésiose

The Babésiose is a rare disease, relationship of the malaria caused by a Babesia ( B. divergens , B. microti ), i.e. a Parasite Protozoaire intra-érythrocytaire affecting several species. The babesia are transmitted by puncture of Tique.

The infection generally causes a haemolytic Anémie by destruction of the red globules. The parasite reproduces while multiplying of two into two attacking the globule which while being lysed, slackens the parasites in blood.

The Babésiose is a Notifiable disease in Quebec.

Epidemiology

The Babesiose is a disease transmitted by a Insecte vector usually a Tique. ( Babesia microti uses the same tick vector, as the disease of Lyme Ixodes scapularis . In the zones of endémie of Babésiose , the parasite can also be transmitted by blood Transfusion.

The parasitic infection by the Babésia can be asymptomatic or to appear by discrete and nonspecific symptoms and much of infections are not indexed like Babésiose. Many cases, among those which are diagnosed, occur among very the young children, the very old people or patients in bad general state (like the immunodéprimés . Certain cases are identified among patients who are reached of another disease transmitted by the ticks, when one seeks the babesiose during a systematic assessment.

One knows little thing on the incidence of the species of Babésia in the zones of Endémie of the malaria where the Babésia can easily be confused with the Plasmodium .

Physiopathology

The parasite Babesia reproduces in the red globules where one can see it with inclusions in the shape of cross (4 Mérozoïte S not differentiated sexually but attached units and forming a structure similar to a Maltese cross and causing a haemolytic Anémie completely similar to that of the malaria.

Contrary to the Plasmodium , the parasite which causes the malaria, the species of Babesia do not have a phase exo-erythrocytaire, also the liver it, usually, is not reached.

Diagnosis

The babésiose can be diagnosed with the direct examination of blood (see the photograph), by the Sérologie, or the tests based on PCR. The tests of laboratory also show a reduction in the number of red globules and of plates to the numeration formulates blood.

Treatment

The majority of the cases of babésiose cure without specific treatment. For the sick patients, the treatment comprises usually the association of two molecules.

the traditional treatment by the Quinine and the Clindamycine is often badly tolerated.
Of the recent studies suggests that an association of Atovaquone and Azithromycine can be also effective.

References

Herwaldt BL, Persing DH, Précigout EA, and Al has fatal puts babesiosis in Missouri off: Identification off another piroplasm that repugnant humans. Ass Intern Med 1996; 124: 643-65.
Pershing DH, Herwaldt BL, Glaser C, and Al Infection with has Babesia-like organism in northern California. NR Engl J Med 1995; 332: 298-303.

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