B. microti is the predominant pathogen in the USA; B. divergens, in Europe [cf. 196]. The transmission <strong>of</strong> the pathogen occurs primarily via ticks. B. microti has been found as a coinfection in LD [197, 198, 199]. Since 1956 a total <strong>of</strong> only 30 cases has been reported in Europe. The majority <strong>of</strong> these patients were splenectomized. 42
The prevalence <strong>of</strong> B. microti <strong>and</strong> B. divergens in ticks is 10% - 20% in Europe [21 - 23], in the USA, <strong>so</strong>metimes higher [24]. The seroprevalence with regard to B. microti <strong>and</strong> B. divergens is 0% in patients with <strong>Lyme</strong> <strong>disease</strong> [25, 26] <strong>and</strong> thus is in stark contrast with the frequency <strong>of</strong> the pathogen in ticks. The situation in the USA is different: there the seroprevalence is approximately 10% - 20% [27 - 30]. In the USA instances <strong>of</strong> the <strong>disease</strong> are reported correspondingly more frequently, in <strong>so</strong>me cases with severe <strong>disease</strong> courses [31 - 34]. This difference can obviously be only explained by the fact that B. microti, the predominant pathogen in the USA, has a very much higher virulence than B. divergens. Thus, Babesiosis dos not play a major role in Europe unless the patient contracted the <strong>disease</strong> in a foreign country, e.g. in the USA. The clinical picture presents as a febrile, influenza-like medical condition with chills <strong>and</strong> fever, arthralgias, myalgias, <strong>and</strong> gastrointestinal symptoms. Severe <strong>disease</strong> courses only occur in non-immunocompetent patients. On base <strong>of</strong> own experiences <strong>chronic</strong> Babesiosis in the European area cannot be excluded definitely. The <strong>disease</strong> is characterized by the following symptoms: marked fatigue, <strong>chronic</strong> sickness, slight fever, air hunger, dyspnea, headache, myalgia, arthralgia, loss <strong>of</strong> appetite, neckstiffness, <strong>so</strong>re throat, unproductive cough, weight loss, nausea, vomiting, diarrhea, haemolytic anemia, thrombocytopenia, elevated transaminases. The treatment is carried out with atovaquone, azithormycin, clindamycin, if necessary in combination with quinine. However, by means <strong>of</strong> the assessment <strong>of</strong> all data, it can be determined that babesiosis—due to the dominant European pathogen, B. divergens—does not 43
- Page 1 and 2: Infectiologic differential diagnosi
- Page 3 and 4: 3 Anamnistically, one has to consid
- Page 5 and 6: Table 2 LD coinfections (not tick-b
- Page 7 and 8: Table 5 Bartonellosis’ infection
- Page 9 and 10: Table 6 Main disease manifestations
- Page 11 and 12: 11 Fig. 1. Erythrocytes infected wi
- Page 13 and 14: 13 Bartonellae are localized in ery
- Page 15 and 16: ESR und CRP elevated Hypercalcemia
- Page 18 and 19: Table 9 Antibiotic treatment of bar
- Page 20 and 21: antibiosis is that the antibiotic i
- Page 22 and 23: The laboratory diagnostics for Chla
- Page 24 and 25: The arthritis occurs in 1% of the u
- Page 26 and 27: In the differential diagnosis of Ly
- Page 28 and 29: Late phase: - Reactive arthritis -
- Page 30 and 31: the depiction of chronic yersiniosi
- Page 32 and 33: In Yersinia-PCR-positive patients,
- Page 34 and 35: - Incubation period 3 weeks - Atypi
- Page 36 and 37: system, of the skin and other organ
- Page 38 and 39: - Ehrlichia chaffeensis [1] - Anapl
- Page 40 and 41: Since seroprevalence merely express
- Page 44 and 45: epresent a major health hazard and
- Page 46 and 47: The decisive diagnostic information
- Page 48 and 49: Probable: IFA IgG 1:1024 and one of
- Page 50 and 51: The main manifestation of the Campy
- Page 52 and 53: The term “reactive arthritis” i
- Page 54 and 55: In the diagnosis of a “reactive a
- Page 56 and 57: Table 27 Disease manifestations of
- Page 58 and 59: addition, other pathogens discussed
- Page 60 and 61: [8] Schouls LM, Van De Pol I, Rijpk
- Page 62 and 63: [25] Hermanowska-Szpakowicz T, Skot
- Page 64 and 65: [43] Bakken JS, Krueth JK, Lund T,
- Page 66 and 67: [60] Fox LM, Wingerter S, Ahmed A e
- Page 68 and 69: [80] Marra CM. Neurologic complicat
- Page 70 and 71: [100] Pulliainen AT, Dehio C. Barto
- Page 72 and 73: [118] Bass JW, Freitas BC, Freitas
- Page 74 and 75: [137] Gaydos CA, Roblin PM, Hammers
- Page 76 and 77: [155] Cover TL, Aber RC. Yersinia e
- Page 78 and 79: multi-organ donors for the presence
- Page 80 and 81: [190] Straubinger RK, Straubinger A
- Page 82 and 83: [208] Bitnun A, Ford-Jones E, Blase
- Page 84 and 85: patients with reactive and undiffer
- Page 86 and 87: [242] Appelbaum PC, Gillespie SH, B
- Page 88 and 89: pneumoniae infection associated wit
- Page 90 and 91: [276] Thomas NH, Collins JE, Robb S
- Page 92 and 93:
[294] File TM Jr, Segreti J, Dunbar
- Page 94 and 95:
[310] Sorvillo FJ, Lieb LE, Waterma
- Page 96 and 97:
henselae Isolates Collected from Ca
- Page 98 and 99:
[345] Raoult D, Levy PY, Harlé JR,
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