Babesiosis as a cause of acute respiratory distress syndrome: a series of eight cases
| Autor: | Marc Y. El Khoury, Priyasha Srivastava, Gary P. Wormser, Oleg Epelbaum, Silvia Alvarez De Leon, Aparna Kadambi, Alberto E Revelo |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty ARDS Lung Diseases Parasitic animal diseases New York 030209 endocrinology & metabolism BABESIA MICROTI Acute respiratory distress 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Babesiosis parasitic diseases Medicine Humans Aged Aged 80 and over Respiratory Distress Syndrome business.industry Age Factors General Medicine Middle Aged medicine.disease Respiration Artificial Intensive Care Units Female business Complication |
| Zdroj: | Postgraduate medicine. 131(2) |
| ISSN: | 1941-9260 |
| Popis: | Objectives: The characteristics of patients with Acute Respiratory Distress Syndrome (ARDS) as a complication of Babesia microti infection have not been systematically described. Methods: Adult patients admitted to the medical intensive care unit (MICU) of a tertiary care hospital in the Lower Hudson Valley of New York from 1/1/2008 to 8/1/2016 were evaluated for ARDS complicating babesiosis. Results: Of 22 patients with babesiosis in the MICU, eight (36.4%; 95% CI: 19.7–57.0%) had ARDS. Six patients (75%) developed ARDS following initiation of anti-babesia drug therapy; however, the mean duration of symptoms in these patients exceeded that of patients who developed ARDS prior to initiation of treatment (7.50 ± 3.83d vs. 4.50 ± 0.71d, p = 0.34). Three patients (37.5%; 95% CI: 13.7–69.4%) expired without recovery from ARDS. In comparison, the mortality rate for the 14 MICU babesiosis patients without ARDS was 14.3% (p = 0.31). There was a trend toward younger age in survivors relative to non-survivors (mean age 54.6 ± 13.8y vs. 74.0 ± 6.24y, p = 0.07). Three of the five survivors did not require mechanical ventilation. The mean sequential organ failure assessment score of non-survivors was significantly higher than that of survivors (12.3 ± 1.15 vs. 6.0 ± 1.4, p = 0.0006). Conclusion: Among 22 critically ill adult patients with B. microti infection, ARDS developed in eight (35.4%), and three (37.5%) expired without resolution of the ARDS. ARDS often followed the initiation of anti-babesia drug therapy, raising the question of whether the death of the parasite per se contributed to its development. However, this observation was confounded by the longer duration of symptoms preceding initiation of drug therapy. |
| Databáze: | OpenAIRE |
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