Summary
Definition
病史和体格检查
其他诊断因素
- constitutional symptoms
- pyrexia
- jaundice
- hepatosplenomegaly
- petechiae, splinter hemorrhages, or ecchymoses
- dark urine
- conjunctival injection
- cough
- sore throat
- photophobia
危险因素
- residence in or travel to an endemic region
- exposure to Ixodes scapularis ticks
- blood transfusion
- asplenia
- immunosuppression
- age >50 years
- Lyme disease
- human granulocytic anaplasmosis
- maternal infection during pregnancy
诊断性检查
首要检查
- peripheral blood smear (Giemsa or Wright stained)
- polymerase chain reaction for babesial DNA
- CBC
- LFTs
- serum creatinine and blood urea nitrogen (BUN)
- urinalysis
- ELISA and/or immunofluorescence assay for Lyme disease
- polymerase chain reaction and/or immunofluorescence assay or buffy coat smear for human granulocytic anaplasmosis
需考虑的检查
- indirect immunofluorescence antibody assay for Babesia microti
- IgG/IgM immunoblot for Lyme disease
- HIV serology
治疗流程
asymptomatic documented infection
mild to moderate disease
acute severe disease
recurrent or refractory disease
撰稿人
作者
Sarah Hochman, MD
Assistant Professor
Department of Medicine
Division of Infectious Diseases and Immunology
New York University School of Medicine
New York
NY
利益声明
SH declares that she has no competing interests.
Louis Weiss, MD, MPH
Professor of Medicine
Division of Infectious Diseases
Professor of Pathology
Division of Parasitology and Tropical Medicine
Albert Einstein College of Medicine
Bronx
NY
利益声明
LW has received grant funding from the National Institute of Allergy and Infectious Diseases. He is also the author of references cited in this topic.
同行评议者
Jeremy Gray, BSc, MSc, PhD
Professor
Department of Environmental Resource Management
University College Dublin
Belfield
Dublin
Republic of Ireland
利益声明
JG declares that he has no competing interests.
Sam Telford III, ScD
Associate Professor of Biomedical Sciences
Division of Infectious Diseases
Cummings School of Veterinary Medicine
Tufts University
Boston
MA
利益声明
ST has active research funding from the NIH. ST is an author or co-author of numerous primary publications on the biology of babesiosis, as well as reviews that have been referenced in this topic.
Raymond J. Dattwyler, MD
Professor of Medicine and Microbiology/Immunology
Chief of Allergy, Immunology and Rheumatology
New York Medical College
Valhalla
NY
利益声明
RJD declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Vannier E, Krause PJ. Human babesiosis. N Engl J Med. 2012;366:2397-2407. 摘要
Centers for Disease Control and Prevention. Tickborne diseases of the United States: a reference manual for health care providers, sixth edition. Aug 2022 [internet publication].全文
Krause PJ, Auwaerter PG, Bannuru RR, et al. Clinical practice guidelines by the Infectious Diseases Society of America (IDSA): 2020 guideline on diagnosis and management of Babesiosis. Clin Infect Dis. 2021 Jan 27;72(2):e49-e64.全文 摘要
Sanchez E, Vannier E, Wormser GP, et al. Diagnosis, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: a review. JAMA. 2016;315:1767-77. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Lyme disease
- Human granulocytic anaplasmosis
- Rocky Mountain spotted fever
更多 鉴别诊断指南
- Tickborne diseases of the United States: a reference manual for health care providers
- 2020 Guideline on diagnosis and management of babesiosis
更多 指南患者教育信息
Lyme disease
Malaria prevention
更多 患者教育信息
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