Transfusion-Associated Babesiosis with an Atypical Time Course after Nonmyeloablative Transplantation for Sickle Cell Disease
Authors: Christopher M. Cirino, Susan F. Leitman, Esther Williams, Daniel Fedorko, Tara N. Palmore, Amy Klion, Christian Ockenhouse, Courtney Fitzhugh, John F. Tisdale, Matthew M. Hsieh
Journal: Annals of Internal Medicine (2008)

Letters20 May 2008Transfusion-Associated Babesiosis with an Atypical Time Course after Nonmyeloablative Transplantation for Sickle Cell DiseaseChristopher M. Cirino, DO, Susan F. Leitman, MD, Esther Williams, Daniel Fedorko, PhD, Tara N. Palmore, MD, Amy Klion, MD, Christian Ockenhouse, MD, PhD, Courtney Fitzhugh, MD, John F. Tisdale, MD, and Matthew M. Hsieh, MDChristopher M. Cirino, DOFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, Susan F. Leitman, MDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, Esther WilliamsFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, Daniel Fedorko, PhDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, Tara N. Palmore, MDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, Amy Klion, MDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, Christian Ockenhouse, MD, PhDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, Courtney Fitzhugh, MDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, John F. Tisdale, MDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this author, and Matthew M. Hsieh, MDFrom St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-10-200805200-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Babesiosis is a tick-borne zoonosis that is increasingly recognized as a transfusion-associated infection (1).Objective: To describe a case of transfusion-associated babesiosis presenting with an atypical time course after nonmyeloablative, peripheral blood stem-cell transplantation.Case Report: A 21-year-old Puerto Rican woman underwent nonmyeloablative peripheral blood stem-cell transplantation at the National Institutes of Health in October 2005 for hydroxyurea-refractory, severe sickle cell disease. Her peritransplant course was unremarkable, hemoglobin level normalized, and hemoglobin electrophoresis revealed donor type (hemoglobin AS). Her last blood product transfusion was in October 2005. She received long-term Pneumocystis prophylaxis with trimethoprim–sulfamethoxazole and underwent periodic therapeutic phlebotomy ...References1. Leiby DA. Babesiosis and blood transfusion: flying under the radar. Vox Sang. 2006;90:157-65. [PMID: 16507014] CrossrefMedlineGoogle Scholar2. Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, et al. 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;43:1089-134. [PMID: 17029130] CrossrefMedlineGoogle Scholar3. Bronsdon MA, Homer MJ, Magera JM, Harrison C, Andrews RG, Bielitzki JT, et al. Detection of enzootic babesiosis in baboons (Papio cynocephalus) and phylogenetic evidence supporting synonymy of the genera Entopolypoides and Babesia. J Clin Microbiol. 1999;37:1548-53. [PMID: 10203519] CrossrefMedlineGoogle Scholar4. Leiby DA, Chung AP, Gill JE, Houghton RL, Persing DH, Badon S, et al. Demonstrable parasitemia among Connecticut blood donors with antibodies to Babesia microti. Transfusion. 2005;45:1804-10. [PMID: 16271108] CrossrefMedlineGoogle Scholar5. Dobroszycki J, Herwaldt BL, Boctor F, Miller JR, Linden J, Eberhard ML, et al. A cluster of transfusion-associated babesiosis cases traced to a single asymptomatic donor. JAMA. 1999;281:927-30. [PMID: 10078490] CrossrefMedlineGoogle Scholar6. Eberhard ML, Walker EM, Steurer FJ. Survival and infectivity of Babesia in blood maintained at 25 C and 2-4 C. J Parasitol. 1995;81:790-2. [PMID: 7472878] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Christopher M. Cirino, DO; Susan F. Leitman, MD; Esther Williams; Daniel Fedorko, PhD; Tara N. Palmore, MD; Amy Klion, MD; Christian Ockenhouse, MD, PhD; Courtney Fitzhugh, MD; John F. Tisdale, MD; Matthew M. Hsieh, MDAffiliations: From St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.Acknowledgment: The authors would like to thank the Reference Diagnostic Laboratory, Division of Parasitic Diseases, Centers for Disease Control and Prevention.Grant Support: This research was supported by the intramural research programs of the National Institute of Diabetes and Digestive and Kidney Diseases, and National Institute of Allergy and Infectious Diseases, and the Warren Grant Magnuson Clinical Center of the National Institutes of Health.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRelapsed Babesia microti Infection Following Allogeneic Hematopoietic Cell Transplantation in a Patient With B-cell Acute Lymphoblastic Leukemia: Case Report and Review of the LiteratureParasitic InfectionsExisting and Emerging Blood-Borne PathogensParasitic Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient, Including Toxoplasmosis and StrongyloidiasisTransfusion-Transmitted Babesia microtiParasites After Hematopoietic Stem Cell or Solid Organ TransplantationInfectious Agents Transmitted by TransfusionThe third described case of transfusion-transmitted Babesia duncaniTransfusion-Associated Babesiosis in the United States: A Description of CasesBarbara L. Herwaldt, MD, MPH, Jeanne V. Linden, MD, MPH, Elizabeth Bosserman, MPH, Carolyn Young, MD, Danuta Olkowska, MD, and Marianna Wilson, MSPersistent babesiosis in a stem cell transplant recipientTransfusion-Transmitted Babesia spp.: Bull's-Eye on Babesia microtiGuidelines for Preventing Infectious Complications among Hematopoietic Cell Transplantation Recipients: A Global PerspectiveReferencesIs the incidence of parasitic lung diseases increasing, and how may this affect modern respiratory medicine?Parasitic lung infectionsTransmission of Babesia microti by blood transfusion in Texas 20 May 2008Volume 148, Issue 10Page: 794-795KeywordsBabesiaBabesiosisBloodCellsFeversHemoglobinParasitemiaPlasmodium falciparumSickle cell diseaseTransplantation ePublished: 20 May 2008 Issue Published: 20 May 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...