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Treatment of Refractory Babesia microti Infection with Atovaquone-Proguanil in an HIV-Infected Patient: Case Report
A patient with acquired immune deficiency syndrome presented with babesiosis 6 months after presumed tick exposure. Despite initial treatment with azithromycin and atovaquone, followed by quinine and clindamycin, he experienced an increasing parasite load. Finally, red blood cell exchange transfusio...
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| Published in: | Clinical infectious diseases 2007-12, Vol.45 (12), p.1588-1560 |
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| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c507t-3ee85e4b0df9e2095ce346997079aec5288f700d6eefcb075f0522bbeed892d43 |
| container_end_page | 1560 |
| container_issue | 12 |
| container_start_page | 1588 |
| container_title | Clinical infectious diseases |
| container_volume | 45 |
| creator | Vyas, Jatin M. Telford, Sam R. Robbins, Gregory K. |
| description | A patient with acquired immune deficiency syndrome presented with babesiosis 6 months after presumed tick exposure. Despite initial treatment with azithromycin and atovaquone, followed by quinine and clindamycin, he experienced an increasing parasite load. Finally, red blood cell exchange transfusion, anti-Babesia therapy, and the addition of atovaquone-proguanil to the treatment regimen led to symptomatic improvement and elimination of parasitemia. Low-level parasitemia recurred 20 weeks later and was eradicated by administration of atovaquone-proguanil monotherapy. Atovaquone-proguanil appears to have activity against babesiosis and should be studied as a potential therapy for patients with refractory babesiosis. |
| doi_str_mv | 10.1086/523731 |
| format | article |
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Despite initial treatment with azithromycin and atovaquone, followed by quinine and clindamycin, he experienced an increasing parasite load. Finally, red blood cell exchange transfusion, anti-Babesia therapy, and the addition of atovaquone-proguanil to the treatment regimen led to symptomatic improvement and elimination of parasitemia. Low-level parasitemia recurred 20 weeks later and was eradicated by administration of atovaquone-proguanil monotherapy. Atovaquone-proguanil appears to have activity against babesiosis and should be studied as a potential therapy for patients with refractory babesiosis.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/523731</identifier><identifier>PMID: 18190320</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Acquired immune deficiency syndrome ; Acquired Immunodeficiency Syndrome - complications ; Acquired Immunodeficiency Syndrome - immunology ; AIDS ; Animals ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiparasitic agents ; Antiretrovirals ; Atovaquone - administration & dosage ; Atovaquone - therapeutic use ; Babesia microti ; Babesiosis ; Babesiosis - complications ; Babesiosis - diagnosis ; Babesiosis - drug therapy ; Biological and medical sciences ; Blood ; Blood transfusion ; Brief Reports ; Case studies ; Drug Combinations ; Drug therapy ; Fever ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunocompromised Host ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infections ; Infectious diseases ; Ixodidae ; Male ; Medical sciences ; Middle Aged ; Parasitemia ; Parasites ; Parasitism ; Pharmacology. Drug treatments ; Proguanil - administration & dosage ; Proguanil - therapeutic use ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>Clinical infectious diseases, 2007-12, Vol.45 (12), p.1588-1560</ispartof><rights>Copyright 2007 The Infectious Diseases Society of America</rights><rights>2007 Infectious Diseases Society of America 2007</rights><rights>2008 INIST-CNRS</rights><rights>Copyright University of Chicago, acting through its Press Dec 15, 2007</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-3ee85e4b0df9e2095ce346997079aec5288f700d6eefcb075f0522bbeed892d43</citedby><cites>FETCH-LOGICAL-c507t-3ee85e4b0df9e2095ce346997079aec5288f700d6eefcb075f0522bbeed892d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4464227$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4464227$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,58236,58469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19940029$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18190320$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vyas, Jatin M.</creatorcontrib><creatorcontrib>Telford, Sam R.</creatorcontrib><creatorcontrib>Robbins, Gregory K.</creatorcontrib><title>Treatment of Refractory Babesia microti Infection with Atovaquone-Proguanil in an HIV-Infected Patient: Case Report</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>A patient with acquired immune deficiency syndrome presented with babesiosis 6 months after presumed tick exposure. Despite initial treatment with azithromycin and atovaquone, followed by quinine and clindamycin, he experienced an increasing parasite load. Finally, red blood cell exchange transfusion, anti-Babesia therapy, and the addition of atovaquone-proguanil to the treatment regimen led to symptomatic improvement and elimination of parasitemia. Low-level parasitemia recurred 20 weeks later and was eradicated by administration of atovaquone-proguanil monotherapy. Atovaquone-proguanil appears to have activity against babesiosis and should be studied as a potential therapy for patients with refractory babesiosis.</description><subject>Acquired immune deficiency syndrome</subject><subject>Acquired Immunodeficiency Syndrome - complications</subject><subject>Acquired Immunodeficiency Syndrome - immunology</subject><subject>AIDS</subject><subject>Animals</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiparasitic agents</subject><subject>Antiretrovirals</subject><subject>Atovaquone - administration & dosage</subject><subject>Atovaquone - therapeutic use</subject><subject>Babesia microti</subject><subject>Babesiosis</subject><subject>Babesiosis - complications</subject><subject>Babesiosis - diagnosis</subject><subject>Babesiosis - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Blood transfusion</subject><subject>Brief Reports</subject><subject>Case studies</subject><subject>Drug Combinations</subject><subject>Drug therapy</subject><subject>Fever</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunocompromised Host</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Ixodidae</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parasitemia</subject><subject>Parasites</subject><subject>Parasitism</subject><subject>Pharmacology. Drug treatments</subject><subject>Proguanil - administration & dosage</subject><subject>Proguanil - therapeutic use</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNqFkV1rFDEUhgdRbK36C0SioHej-Zwk3tVVuwsFa6kfeBMymTOa7c5km2TU_ntTZmlFEK8SeJ-8J8lTVQ8JfkGwal4KyiQjt6p9IpisG6HJ7bLHQtVcMbVX3UtpjTEhCou71R5RRGNG8X6VziLYPMCYUejRKfTRuhziJXptW0jeosG7GLJHq7EHl30Y0U-fv6PDHH7YiymMUJ_E8G2yo98gPyI7ouXqUz3T0KETm30pf4UWNkHp34aY71d3ertJ8GC3HlQf3709Wyzr4_dHq8Xhce0ElrlmAEoAb3HXa6BYCweMN1pLLLUFJ6hSvcS4awB612IpeiwobVuATmnacXZQPZ97tzFcTJCyGXxysNnYEcKUTDnMFdfqvyDFSnCmdQGf_gWuwxTH8ghDidZNI8kfY8vHpRShN9voBxsvDcHmSpaZZRXw8a5tagfobrCdnQI82wE2Obspbkbn0w2nNceYXl3rycyFafvvYY9mZp2K32uK84ZTKktcz7FPGX5dxzaem0YyKczyy1ezPOISn775YD6z3xBIvVg</recordid><startdate>20071215</startdate><enddate>20071215</enddate><creator>Vyas, Jatin M.</creator><creator>Telford, Sam R.</creator><creator>Robbins, Gregory K.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20071215</creationdate><title>Treatment of Refractory Babesia microti Infection with Atovaquone-Proguanil in an HIV-Infected Patient: Case Report</title><author>Vyas, Jatin M. ; Telford, Sam R. ; Robbins, Gregory K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-3ee85e4b0df9e2095ce346997079aec5288f700d6eefcb075f0522bbeed892d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Acquired Immunodeficiency Syndrome - complications</topic><topic>Acquired Immunodeficiency Syndrome - immunology</topic><topic>AIDS</topic><topic>Animals</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiparasitic agents</topic><topic>Antiretrovirals</topic><topic>Atovaquone - administration & dosage</topic><topic>Atovaquone - therapeutic use</topic><topic>Babesia microti</topic><topic>Babesiosis</topic><topic>Babesiosis - complications</topic><topic>Babesiosis - diagnosis</topic><topic>Babesiosis - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Blood transfusion</topic><topic>Brief Reports</topic><topic>Case studies</topic><topic>Drug Combinations</topic><topic>Drug therapy</topic><topic>Fever</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunocompromised Host</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Ixodidae</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Parasitemia</topic><topic>Parasites</topic><topic>Parasitism</topic><topic>Pharmacology. Drug treatments</topic><topic>Proguanil - administration & dosage</topic><topic>Proguanil - therapeutic use</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vyas, Jatin M.</creatorcontrib><creatorcontrib>Telford, Sam R.</creatorcontrib><creatorcontrib>Robbins, Gregory K.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vyas, Jatin M.</au><au>Telford, Sam R.</au><au>Robbins, Gregory K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of Refractory Babesia microti Infection with Atovaquone-Proguanil in an HIV-Infected Patient: Case Report</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2007-12-15</date><risdate>2007</risdate><volume>45</volume><issue>12</issue><spage>1588</spage><epage>1560</epage><pages>1588-1560</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>A patient with acquired immune deficiency syndrome presented with babesiosis 6 months after presumed tick exposure. 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| ispartof | Clinical infectious diseases, 2007-12, Vol.45 (12), p.1588-1560 |
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| source | JSTOR Archival Journals and Primary Sources Collection; Oxford Journals Online |
| subjects | Acquired immune deficiency syndrome Acquired Immunodeficiency Syndrome - complications Acquired Immunodeficiency Syndrome - immunology AIDS Animals Antibiotics. Antiinfectious agents. Antiparasitic agents Antiparasitic agents Antiretrovirals Atovaquone - administration & dosage Atovaquone - therapeutic use Babesia microti Babesiosis Babesiosis - complications Babesiosis - diagnosis Babesiosis - drug therapy Biological and medical sciences Blood Blood transfusion Brief Reports Case studies Drug Combinations Drug therapy Fever Human immunodeficiency virus Human viral diseases Humans Immunocompromised Host Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infections Infectious diseases Ixodidae Male Medical sciences Middle Aged Parasitemia Parasites Parasitism Pharmacology. Drug treatments Proguanil - administration & dosage Proguanil - therapeutic use Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Treatment of Refractory Babesia microti Infection with Atovaquone-Proguanil in an HIV-Infected Patient: Case Report |
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