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Babesiosi: che cos’è e come si trasmette




Che cos’è la babesiosi ?

La babesiosi è una patologia trasmessa da zecche causata da protozoi intraeritrocitari del genere Babesia originariamente descritti da Babes nel 1888 in bovini e ovini. I sintomi di solito esordiscono 1-4 settimane dopo il morso di una zecca infetta, o 1-6 mesi dopo trasfusione con sangue contaminato.

 

Eziologia

 

Diverse specie di protozoi intracellulari del genere babesia provocano delle zoonosi e sono occasionalmente trasmesse all’uomo da zecche dei roditori. La trasmissione per trasfusione sanguigna è possibile. L’infezione si osserva nell’uomo soprattutto in caso di immunodepressione (infezione opportunistica) o di splenectomia.




Babesiosi: manifestazioni cliniche

Circa un quarto delle infezioni da babesiosi microti negli adulti e la metà di quelle osservate nei bambini decorrono in maniera asintomatica. Nei casi sintomatici si osserva la comparsa graduale di febbre (intermittente o continua), malessere generale, astenia, mialgia e cefalea. L’esame obiettivo può mostrare epatosplenomegalia. La forma europea provocata da babesiosi divergens presenta un esordio brusco con febbre elevata (40-41 C), brividi scuotenti, cefalea, mialgie ed emoglobinuria. Il decorso può essere caratterizzato dall’insorgenza di insufficienza multiorgano, responsabile della morte nei pazienti immunocompromessi.

Esami di laboratorio

La diagnosi è confermata dalla ricerca delle forme intraeritrocitarie  del parassita (esame dello striscio, inoculazione in una cavia) e da test sierologici.




Terapia

Per le forme causate da babesiosi microti di gravità lieve-moderata si impiega una combinazione di atovaquone e azitromicina che si è dimostrata di pari efficacia alla terapia con clindamicina e chinina. Quest’ultima combinazione per via parentale viene invece utilizzata nelle forme gravi. Nei pazienti immunocompromessi possono essere necessari cicli terapeutici ripetuti per negativizzare la parassitemia. In presenza di parassitemia elevata (>10%) associata a insufficienza d’organo o emolisi importante può essere necessario ricorrere all’exsanguinotrasfusione.




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Caratteristiche del Babesia microti trasmesso per trasfusione, Croce Rossa americana 2010-2017




 

 

4 pensieri riguardo “Babesiosi: che cos’è e come si trasmette

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