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Volume 22, Number 11—November 2016
CME ACTIVITY - Synopsis

Transmission of Babesia microti Parasites by Solid Organ Transplantation

Meghan B. BrennanComments to Author , Barbara L. Herwaldt, James J. Kazmierczak, John W. Weiss, Christina L. Klein, Catherine P. Leith, Rong He, Matthew J. Oberley, Laura Tonnetti, Patricia P. Wilkins, and Gregory M. Gauthier
Author affiliations: University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA (M.B. Brennan, J.W. Weiss, C.L. Klein, C.P. Leith, R. He, M.J. Oberley, G.M. Gauthier); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.L. Herwaldt, P.P. Wilkins); Wisconsin Division of Public Health, Madison (J.J. Kazmierczak); American Red Cross Badger–Hawkeye Blood Service Region, Madison (J.W. Weiss); American Red Cross Jerome H. Holland Laboratories for the Biomedical Sciences, Rockville, Maryland, USA (L. Tonnetti)

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Figure 3

Computed tomography (CT) scan of the abdomen of patient B, a renal transplant recipient infected with Babesia microti parasites, Wisconsin, USA, 2008. Taken on November 5, the scan shows a splenic infarction (white arrow) that had not been visualized on a CT scan on October 5. Although the cause of the splenic infarction was not determined, the infarction might have been a complication of babesiosis, as reported for other patients (16,17).

Figure 3. Computed tomography (CT) scan of the abdomen of patient B, a renal transplant recipient infected with Babesia microti parasites, Wisconsin, USA, 2008. Taken on November 5, the scan shows a splenic infarction (white arrow) that had not been visualized on a CT scan on October 5. Although the cause of the splenic infarction was not determined, the infarction might have been a complication of babesiosis, as reported for other patients (16,17).

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References
  1. Pfeiffer  CD, Kazmierczak  JJ, Davis  JP. Epidemiologic features of human babesiosis in Wisconsin, 1996-2005. WMJ. 2007;106:1915.PubMedGoogle Scholar
  2. Vannier  E, Krause  PJ. Human babesiosis. N Engl J Med. 2012;366:2397407.DOIPubMedGoogle Scholar
  3. Herwaldt  BL, Montgomery  S, Woodhall  D, Bosserman  EA; Centers for Disease Control and Prevention (CDC). Babesiosis surveillance - 18 States, 2011. MMWR Morb Mortal Wkly Rep. 2012;61:5059.PubMedGoogle Scholar
  4. Kowalski  TJ, Jobe  DA, Dolan  EC, Kessler  A, Lovrich  SD, Callister  SM. The emergence of clinically relevant babesiosis in southwestern Wisconsin. WMJ. 2015;114:1527.PubMedGoogle Scholar
  5. Hatcher  JC, Greenberg  PD, Antique  J, Jimenez-Lucho  VE. Severe babesiosis in Long Island: review of 34 cases and their complications. Clin Infect Dis. 2001;32:111725.DOIPubMedGoogle Scholar
  6. Wormser  GP, Dattwyler  RJ, Shapiro  ED, Halperin  JJ, Steere  AC, Klempner  MS, The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43:1089134.DOIPubMedGoogle Scholar
  7. Herwaldt  BL, Neitzel  DF, Gorlin  JB, Jensen  KA, Perry  EH, Peglow  WR, Transmission of Babesia microti in Minnesota through four blood donations from the same donor over a 6-month period. Transfusion. 2002;42:11548.DOIPubMedGoogle Scholar
  8. Tonnetti  L, Eder  AF, Dy  B, Kennedy  J, Pisciotto  P, Benjamin  RJ, Transfusion-transmitted Babesia microti identified through hemovigilance. Transfusion. 2009;49:255763.DOIPubMedGoogle Scholar
  9. Asad  S, Sweeney  J, Mermel  LA. Transfusion-transmitted babesiosis in Rhode Island. Transfusion. 2009;49:256473.DOIPubMedGoogle Scholar
  10. Herwaldt  BL, Linden  JV, Bosserman  E, Young  C, Olkowska  D, Wilson  M. Transfusion-associated babesiosis in the United States: a description of cases. Ann Intern Med. 2011;155:50919.DOIPubMedGoogle Scholar
  11. Leiby  DA. Transfusion-transmitted Babesia spp.: bull’s-eye on Babesia microti. Clin Microbiol Rev. 2011;24:1428.DOIPubMedGoogle Scholar
  12. Chisholm  ES, Ruebush  TK II, Sulzer  AJ, Healy  GR. Babesia microti infection in man: evaluation of an indirect immunofluorescent antibody test. Am J Trop Med Hyg. 1978;27:149.PubMedGoogle Scholar
  13. Persing  DH, Mathiesen  D, Marshall  WF, Telford  SR, Spielman  A, Thomford  JW, Detection of Babesia microti by polymerase chain reaction. J Clin Microbiol. 1992;30:2097103.PubMedGoogle Scholar
  14. Torres-Vélez  FJ, Nace  EK, Won  KY, Bartlett  J, Eberhard  M, Guarner  J. Development of an immunohistochemical assay for the detection of babesiosis in formalin-fixed, paraffin-embedded tissue samples. Am J Clin Pathol. 2003;120:8338.DOIPubMedGoogle Scholar
  15. Belzer  FO, D’Alessandro  AM, Hoffmann  RM, Knechtle  SJ, Reed  A, Pirsch  JD, The use of UW solution in clinical transplantation. A 4-year experience. Ann Surg. 1992;215:57983, discussion 584–5.DOIPubMedGoogle Scholar
  16. Florescu  D, Sordillo  PP, Glyptis  A, Zlatanic  E, Smith  B, Polsky  B, Splenic infarction in human babesiosis: two cases and discussion. Clin Infect Dis. 2008;46:e811.DOIPubMedGoogle Scholar
  17. El Khoury  MY, Gandhi  R, Dandache  P, Lombardo  G, Wormser  GP. Non-surgical management of spontaneous splenic rupture due to Babesia microti infection. Ticks Tick Borne Dis. 2011;2:2358.DOIPubMedGoogle Scholar
  18. Gupta  P, Hurley  RW, Helseth  PH, Goodman  JL, Hammerschmidt  DE. Pancytopenia due to hemophagocytic syndrome as the presenting manifestation of babesiosis. Am J Hematol. 1995;50:602.DOIPubMedGoogle Scholar
  19. Slovut  DP, Benedetti  E, Matas  AJ. Babesiosis and hemophagocytic syndrome in an asplenic renal transplant recipient. Transplantation. 1996;62:5379.DOIPubMedGoogle Scholar
  20. Evenson  DA, Perry  E, Kloster  B, Hurley  R, Stroncek  DF. Therapeutic apheresis for babesiosis. J Clin Apher. 1998;13:326.DOIPubMedGoogle Scholar
  21. Perdrizet  GA, Olson  NH, Krause  PJ, Banever  GT, Spielman  A, Cable  RG. Babesiosis in a renal transplant recipient acquired through blood transfusion. Transplantation. 2000;70:2058.PubMedGoogle Scholar
  22. Lux  JZ, Weiss  D, Linden  JV, Kessler  D, Herwaldt  BL, Wong  SJ, Transfusion-associated babesiosis after heart transplant. Emerg Infect Dis. 2003;9:1169.DOIPubMedGoogle Scholar
  23. Iwamoto  M, Jernigan  DB, Guasch  A, Trepka  MJ, Blackmore  CG, Hellinger  WC, ; West Nile Virus in Transplant Recipients Investigation Team. Transmission of West Nile virus from an organ donor to four transplant recipients. N Engl J Med. 2003;348:2196203.DOIPubMedGoogle Scholar
  24. Stanley  E, Ratard  R, Staples  JE, Royce  R, Bower  WA, Ellingson  KD, ; Centers for Disease Control and Prevention (CDC). West Nile virus transmission via organ transplantation and blood transfusion - Louisiana, 2008. MMWR Morb Mortal Wkly Rep. 2009;58:12637.PubMedGoogle Scholar
  25. Etkind  P, Piesman  J, Ruebush  TK II, Spielman  A, Juranek  DD. Methods for detecting Babesia microti infection in wild rodents. J Parasitol. 1980;66:10710.DOIPubMedGoogle Scholar
  26. Vyas  JM, Telford  SR, Robbins  GK. Treatment of refractory Babesia microti infection with atovaquone-proguanil in an HIV-infected patient: case report. Clin Infect Dis. 2007;45:158890.DOIPubMedGoogle Scholar
  27. Krause  PJ, Gewurz  BE, Hill  D, Marty  FM, Vannier  E, Foppa  IM, Persistent and relapsing babesiosis in immunocompromised patients. Clin Infect Dis. 2008;46:3706.DOIPubMedGoogle Scholar
  28. Wormser  GP, Prasad  A, Neuhaus  E, Joshi  S, Nowakowski  J, Nelson  J, Emergence of resistance to azithromycin-atovaquone in immunocompromised patients with Babesia microti infection. Clin Infect Dis. 2010;50:3816.DOIPubMedGoogle Scholar
  29. Krause  PJ, Lepore  T, Sikand  VK, Gadbaw  J Jr, Burke  G, Telford  SR III, Atovaquone and azithromycin for the treatment of babesiosis. N Engl J Med. 2000;343:14548.DOIPubMedGoogle Scholar
  30. Sanchez  E, Vannier  E, Wormser  GP, Hu  LT. Diagnosis, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: a review. JAMA. 2016;315:176777.DOIPubMedGoogle Scholar
  31. Leiby  DA, Johnson  ST, Won  KY, Nace  EK, Slemenda  SB, Pieniazek  NJ, A longitudinal study of Babesia microti infection in seropositive blood donors. Transfusion. 2014;54:221725.DOIPubMedGoogle Scholar
  32. Leiby  DA. Transfusion-associated babesiosis: shouldn’t we be ticked off? Ann Intern Med. 2011;155:5567.DOIPubMedGoogle Scholar
  33. Gubernot  DM, Nakhasi  HL, Mied  PA, Asher  DM, Epstein  JS, Kumar  S. Transfusion-transmitted babesiosis in the United States: summary of a workshop. Transfusion. 2009;49:275971.DOIPubMedGoogle Scholar
  34. AABB. Babesiosis. Association Bulletin #14–05. 2014 July 18 [cited 2016 Mar 20]. http://www.aabb.org/programs/publications/bulletins/Documents/ab14-05.pdf.
  35. Snyder  EL, Stramer  SL, Benjamin  RJ. The safety of the blood supply—time to raise the bar. N Engl J Med. 2015;372:18825.DOIPubMedGoogle Scholar
  36. Food and Drug Administration; Meeting of the Blood Products Advisory Committee. Strategies for implementation of antibody and nucleic acid-based testing for Babesia microti in blood donors, May 13, 2015 [cited 2016 Mar 20]. http://www.fda.gov/AdvisoryCommittees/CommitteesMeetingMaterials/BloodVaccinesandOtherBiologics/BloodProductsAdvisoryCommittee/ucm441228.htm

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Page created: October 12, 2016
Page updated: October 17, 2016
Page reviewed: October 17, 2016
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