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 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is currently less than a one in a million chance that a blood transfusion within the United States will be complicated by a parasitic infection. However, changes in population demographics and increases in international travel and immigration may all contribute to an increase in the number of parasitemic individuals who present as prospective blood donors. Consequently, a need may arise to develop new policies to prevent transfusion-transmitted parasitic infections. In the present review, the following parasitic infections of concern to the safety of the US blood supply will be discussed: malaria, Chagas' disease, babesiosis, leishmaniasis, toxoplasmosis, and microfilariasis.
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PMID:Parasitic infections and their impact on blood donor selection and testing. 816 86

Babesiosis is a malaria-like parasitic disease causing subclinical or mild illness in most cases. Splenectomized patients, however, may experience a more severe course. Although generally responsive to antibiotic therapy, several cases of severe babesiosis refractory to appropriate antibiotic therapy have been reported to respond promptly and dramatically to red blood cell (RBC) exchange transfusion. Although the role of HIV coinfection in babesiosis is uncertain, two previously reported cases raise a concern that it may predispose to a more severe clinical course. We report a third case of severe babesiosis in an HIV-positive splenectomized man, following travel to an endemic area. Antibiotic therapy, though initially effective, ultimately failed to prevent severe disease. RBC exchange transfusion resulted in prompt clinical improvement, which has been sustained during 26 months of follow-up. Although the patient has since developed various sequelae of HIV infection, including disseminated Kaposi's sarcoma, CMV retinitis, and enteritis, there has been no recurrence of observable parasitemia. In severe babesiosis, RBC exchange transfusion, combined with appropriate antibiotic therapy, appears to be a rapidly effective therapeutic modality which can induce sustained remissions.
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PMID:Treatment of babesiosis by red blood cell exchange in an HIV-positive, splenectomized patient. 822 9

Quantitative Buffy Coat analysis and blood smears were performed on a total of 47 blood samples. The technique showed 100% correlation with the blood smears in 9 samples containing babesia and 10 samples containing malaria, with some differential features distinguishing the two infections. Quantitative Buffy Coat analysis provides a simple and rapid method for the detection of parasitemia in cases of babesiosis.
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PMID:Use of the Quantitative Buffy Coat system for detection of parasitemia in patients with babesiosis. 825 95

Just over a year ago, the Occupational Safety and Health Administration (OSHA) issued the final bloodborne pathogens standard, "Occupational Exposure to Bloodborne Pathogens; Final Rule," which requires healthcare institutions to protect their employees from all occupational exposure to bloodborne pathogens." According to OSHA, the only criterion for applying the standard is the likelihood of exposure to blood and other potentially infectious materials (OPIMs). Thus, the standard is designed to protect all vulnerable personnel, from the clinical engineers who service contaminated equipment to the staff in clinical laboratories, patient care or treatment areas, and housekeeping and laundry services--any location where the nature of the work poses the risk of exposure to bloodborne pathogens. All department heads and employees must have access to the standard and should carefully review our analysis of the regulations and recommendations for implementing them, as presented in this special issue of Health Devices. The standard is aimed at protecting employees from occupational exposure to all bloodborne pathogens and, especially, to the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV)--the most infamous pathogens transmitted through occupational exposure to blood and body fluids. Other bloodborne diseases referenced by OSHA in the preamble to the standard include arboviral infections, babesiosis, brucellosis, Creutzfeldt-Jakob disease, hepatitis C, human T-lymphotropic virus type I, leptospirosis, malaria, relapsing fever, syphilis, and viral hemorrhagic fever. In this issue, we provide a clinical overview of HIV and HBV and the diseases they cause, as well as a brief discussion of other bloodborne pathogens; an analysis of the most significant regulations affecting hospitals; and our recommendations for compliance. The recommendations presented in this article do not exhaust the possibilities for reducing exposure and complying with the standard. We invite you to communicate your ideas and practices regarding compliance issues to the ECRI-sponsored Center for Healthcare Environmental Management (CHEM) for possible inclusion in a future update to its loose-leaf reference publication, the Healthcare Environmental Management System. We wish to acknowledge CHEM's contribution in developing this special report, which was reviewed by the Centers for Disease Control and Prevention (CDC), the National Institute for Occupational Safety and Health (NIOSH), and OSHA. Also see "CDC's Recommendations for Hepatitis B Vaccination and Postexposure Follow-up" and "A Minimal Training Syllabus" in this issue.
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PMID:OSHA's bloodborne pathogens standard: analysis and recommendations. 844 29

Specific treatment of canine babesiosis consists of antibabesial drugs and, in severely anaemic animals, blood transfusion. Supportive therapy is also required, particularly in animals with complicated disease. Strategies for treatment of uncomplicated and complicated babesiosis are discussed. Definitive recommendations cannot be provided on the basis of available information, but suggestions are made, based on accepted therapeutic principles, pathophysiological mechanisms, therapy used in human malaria, and clinical experience. The problems of fluid therapy in complicated babesiosis, particularly in animals with oliguria, cerebral babesiosis and pulmonary oedema, are presented, with consideration given to the use of hypertonic fluids. The benefits of bicarbonate and alternative alkalinisers in life-threatening lactic acidaemia, a relatively common occurrence in complicated babesiosis, are debated, as are the benefits of oxygen therapy in anaemic hypoxia. Drug therapy and management of specific babesial complications are discussed. The rationale for supportive drugs commonly used in uncomplicated babesiosis, including lipotropic agents, haematinics and glucocorticoids, is examined. This review is designed to propose therapeutic guidelines and to stimulate interest in problematic aspects of supportive therapy for canine babesiosis.
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PMID:Supportive treatment of canine babesiosis. 854 69

Uncomplicated canine babesiosis was diagnosed in 2 dogs based on the presence of trophozoites of Babesia canis in red blood cells on examination of a peripheral blood smear. The haemogram picture was that of a leukaemoid response with severe anaemia, high total white cell count and thrombocytopaenia. Treatment with babesiacidal drugs, together with blood transfusion, was successful in eliminating the Babesia parasites and reducing the leukaemoid response. The various leukograms of canine babesiosis and human malaria are compared and briefly discussed.
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PMID:Leukaemoid response in two dogs with Babesia canis infection. 859 92

Babesiosis is a malaria-like, tick-transmitted zoonosis caused by protozoa of the family Piroplasmorida, which includes Babesia and Theileria species. In the United States, the infection is endemic in the Northeast and upper Midwest, although cases have recently been described in Northern California and Washington State. We report a case of babesiosis in a patient infected with HIV who presented with a prolonged fever of unknown origin; the patient had not undergone splenectomy. Parasitemia persisted despite initial clinical improvement after treatment with quinine and clindamycin. Babesiosis was controlled with a maintenance regimen consisting of clindamycin, doxycycline, and high-dose azithromycin, but the infection was not eradicated. Babesiosis should be considered in the differential diagnosis of HIV-infected patients with fevers and/or anemia in areas where the infection is endemic. HIV-infected patients who are severely immunosuppressed, even those without a history of splenectomy, may present with severe manifestations of babesiosis and develop a chronic infection, which may require therapy to prevent relapse of disease.
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PMID:Babesiosis in patients with AIDS: a chronic infection presenting as fever of unknown origin. 872 36

Several bacterial and parasite transfusion-transmitted diseases have been described in the medical literature. This review deals with the main bacterial (Syphilis, Lyme disease, Gram positive and Gram negative agents), parasite (Chagas disease, malaria, leishmaniasis, toxoplasmosis and babesiosis) and rickettsial diseases that are carried by blood products. Preventional aspects (e.g. storage, screening tests, use of leukocyte-depleted components), diagnosis, geographical distribution and the incidence of these transfusional hazards are also discussed.
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PMID:Current concepts on the transmission of bacteria and parasites by blood components. 873 Dec 90

Babesiosis is a malaria-like illness transmitted by the tick Ixodes dammini. The disease is endemic to the Northeast coastal region and parts of the Midwest. Symptoms-which include fever, anemia, elevated liver function tests, and hemoglobinuria-may be especially severe in asplenic or immunocompromised patients. In rare cases, infection with Babesia may be associated with marked pancytopenia. Bone marrow biopsy may reveal hemophagocytosis and marrow histiocytosis. We report a severe case of babesiosis and hemophagocytic syndrome in an asplenic renal transplant patient.
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PMID:Babesiosis and hemophagocytic syndrome in an asplenic renal transplant recipient. 878 22

The pathophysiology of diseases produced by protozoal infections is caused not only by a direct effect of the parasites on their host (e.g. host cell lysis or parasite adherence), but also by indirect effects, where molecules of parasite origin exert an effect on host cells, which in turn produces a cascade of events (including the secretion of inflammatory cytokines, prostaglandins and nitric oxide) responsible for the symptomatology observed. The role of the host itself in the pathogenic events is not negligeable and its genetic background, nutritional and immunological status will influence the outcome of the infection (which will result in asymptomatic infections in some individuals and severe disease in others). The general and specific features of a variety of protozoal infections of medical and veterinary importance (including malaria, babesiosis, trypanosomiasis, toxoplasmosis, cryptosporidiosis, amoebiasis, giardiasis and trichomoniasis) are discussed in this review and a number of common patterns are identified.
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PMID:[Physiopathology of protozoan infections]. 895 86


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