Japanese
healthy donor transmitted case of Babesiosis:
PubMed search: Babesi*+Japan: http://www.ncbi.nlm.nih.gov/pubmed?term=Babesi*+Japan
PubMed search Babesi*+Japan+donor: http://www.ncbi.nlm.nih.gov/pubmed?term=Babesi*+Japan+donor
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Rinsho
Ketsueki. 2000 Aug;41(8):628-34. |
[First
documentation of transfusion-associated babesiosis in Japan]
[Article in Japanese]
Matsui T, Inoue R, Kajimoto K, Tamekane A, Okamura A, Katayama Y, Shimoyama
M, Chihara K, Saito-Ito A, Tsuji M.
Department of Medicine, Kobe University School of Medicine.
A 40-year-old man received blood transfusion in
December 1998 because of gastric bleeding from a peptic ulcer. One
month later, he developed febrile hemolytic anemia. Administration of high
doses of glucocorticoid significantly reduced the hemolysis, but did not cure
the disease. To investigate the cause of the hemolysis, the patient was
transferred to our hospital in May 1999. Giemsa-stained
peripheral blood smears showed Babesia parasites in the red blood cells (RBC),
and PCR analysis confirmed the presence of Babesia microti DNA. The
parasitemia disappeared hematologically after 2 weeks of quinine and
clindamycin therapy. However, parasite DNA was still detectable in the RBC. Although treatment with oral atovaquone was given for 2
weeks, parasitemia and febrile hemolysis recurred within a month after the last
treatment. Fortunately, complete
remission was obtained after a second 12-week
course of therapy with quinine and clindamycin. PCR analysis
revealed asymptomatic Babesia infection in one of eight samples from the
original blood donor. The initial steroid therapy given to the patient without
an accurate diagnosis seemed to have delayed augmentation of the specific
antibodies (IgG) against Babesia microti, thus prolonging the parasitemia after
the initial acute stage of babesiosis.
Publication Types:
·
Case
Reports
PMID: 11020989 [PubMed - indexed for MEDLINE]
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J Clin Microbiol.
2000 Dec;38(12):4511-6. |
Transfusion-acquired,
autochthonous human babesiosis in Japan: isolation of Babesia microti-like
parasites with hu-RBC-SCID mice.
Saito-Ito A, Tsuji M, Wei Q, He S, Matsui T, Kohsaki M, Arai S, Kamiyama T,
Hioki K, Ishihara C.
Department of Medical Zoology, Kobe 650-0017, School of Veterinary Medicine,
Rakuno-gakuen University, Ebetsu 069-8501, Japan.
We have isolated piroplasms from a patient who
developed the first case of human babesiosis in Japan by using NOD/shi-scid
mice whose circulating erythrocytes (RBCs) had been replaced with human RBCs
(hu-RBC-SCID mice). Following inoculation of the patient's blood
specimen into hu-RBC-SCID mice, parasites proliferated within the human RBCs in
the mice, resulting in a high level of parasitemia. Parasite DNA was prepared
from blood samples of the patient and the mice, and the nuclear small-subunit
rRNA gene (rDNA) was amplified and sequenced. Both DNA samples gave rise to
identical sequences which showed the highest degree of homology (99.2%) with
the Babesia microti rDNA. Because the patient
had received a blood transfusion before the onset of babesiosis, we
investigated the eight donors who were involved. Their archived
blood samples were analyzed for specific antibody and parasite DNA; only a single donor was found to be positive by both tests,
and the parasite rDNA sequence from the donor coincided with that derived from
the patient. The donor's serum exhibited
a high antibody titer against the isolate from the patient, whereas it
exhibited only a weak cross-reaction against B. microti strains isolated in the
United States. We
conclude that the first Japanese babesiosis case occurred due to a blood
transfusion and that the etiological agent is an indigenous Japanese parasite
which may be a geographical variant of B. microti. Our results also
demonstrated the usefulness of hu-RBC-SCID mice for isolation of parasites from
humans and for maintenance of the parasite infectivity for human RBCs.
PMID: 11101588 [PubMed - indexed for MEDLINE]
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J Clin
Microbiol. 2001 Jun;39(6):2178-83. |
Human
babesiosis in Japan: isolation of Babesia microti-like parasites from an
asymptomatic transfusion donor and from a rodent from an area where babesiosis
is endemic.
Wei Q, Tsuji M, Zamoto A,
Kohsaki M, Matsui T, Shiota T, Telford SR 3rd, Ishihara C.
School of Veterinary
Medicine, Rakuno-Gakuen University, 582-1 Bunkyodai-Midorima-chi, Ebetsu
069-8501, Japan.
To determine the source of infection for the Japanese index case of human
babesiosis, we analyzed blood samples from an
asymptomatic individual whose blood had been transfused into the patient.
In addition, we surveyed rodents collected from near
the donor's residence. Examination
by microscopy and PCR failed to detect the parasite in the donor's blood
obtained 8 months after the donation of the blood that was transfused. However, we were able to isolate Babesia parasites by inoculating the
blood sample into SCID mice whose circulating red blood cells (RBCs) had
been replaced with human RBCs. A Babesia parasite capable of propagating in human RBCs was also
isolated from a field mouse (Apodemus speciosus) captured near the donor's
residential area. Follow-up surveys over a
1-year period revealed that the donor continued to be asymptomatic but had consistently
high immunoglobulin G (IgG) titers in serum and low levels of parasitemia
which were microscopically undetectable yet which were repeatedly demonstrable
by inoculation into animals. The index case patient's sera contained high titers of IgM and,
subsequently, rising titers of IgG antibodies, both of which gradually
diminished with the disappearance of the parasitemia. Analysis of the
parasite's rRNA gene (rDNA) sequence and immunodominant antigens revealed the
similarity between donor and patient isolates. The rodent isolate also had an
rDNA sequence that was identical to that of the human isolates but that
differed slightly from that of the human isolates by Western blot analysis. We
conclude that the index case patient acquired infection by transfusion from a
donor who became infected in Japan, that parasitemia in an asymptomatic carrier
can persist for more than a year, and that A. speciosus serves as a reservoir
of an agent of human babesiosis in Japan.
PMID: 11376054 [PubMed - indexed for MEDLINE]