患者,男,67岁,美籍华人,2023年8月28日晚(美国当地时间)出现发热症状,最高体温39.7 ℃.于8月29日在哈佛医学院麻省总院就诊,胸片提示双侧磨玻璃影,诊断为肺炎,予以阿奇霉素、苯佐那酯、阿莫西林、愈创木酚口服治疗.患者于8月31日(北京时间)到达珠海,因持续发热,于9月1日前往中山大学附属第五医院就诊.患者长期居住在美国新罕布什尔州(巴贝虫流行州),有虫子叮咬史.血常规示血红蛋白93.00 g/L↓,嗜酸粒细胞0.00 × 109/L ↓.尿常规示尿隐血4+↑,尿蛋白2+↑.血涂片镜检可见红细胞内有田鼠巴贝虫(Babesia microti)虫体.血样荧光定量PCR扩增显示巴贝虫阳性.宏基因组二代测序检测出1 338 308条田鼠巴贝虫序列.予米诺环素(每次0.1 g,12 h 1次)+克林霉素(每次0.6 g,6 h 1次)抗感染治疗.9月11日,患者好转出院.出院前血常规示血红蛋白76.00 g/L,血小板计数208.00 × 109/L,谷丙转氨酶39.60 U/L,谷草转氨酶37.20 U/L.出院后2个月随访,患者恢复良好.
The first imported case of human Babesia microti infection in Zhuhai City
The patient was a 67-year-old male American Chinese.On the evening of August 28th,2023(US local time),the patient developed fever symptoms,with a maximum body temperature of 39.7 ℃.On August 29th(US local time),he visited the Massachusetts General Hospital of Harvard Medical School.Chest X-ray showed bilateral ground glass shadows,diagnosed with"pneumonia",and was treated orally with"azithromycin,benzoate,amoxicillin,and guaiacol".The patient arrived in Zhuhai on August 31st(Beijing time).On September 1st,he sought medical at-tention at the Fifth Affiliated Hospital of Sun Yat-sen University due to persistent fever symptoms.Admission examina-tion:hemoglobin 93.00 g/L ↓,eosinophils 0.00 × 109/L ↓,urinary occult blood 4+↑,urinary protein 2+↑.Microscopic examination of blood smear revealed the presence of Babesia microti in red blood cells.Metagenomic next-generation sequencing(mNGS)detection of 1 338 308 sequences of Babesia microti.The patient has been residing in New Hamp-shire,USA(Babesia epidemic area)for a long time,and had a history of insect bites.The next-generation sequencing results showed positive results for Babesia microti.The patient was treated with minocycline(0.1 g each time,once ev-ery 12 hours)+clindamycin(0.6 g each time,once every 6 hours)for anti-infection.After treatment,the condition im-proved,and the patient was discharged on September 11th.The blood count prior to discharge showed:hemoglobin 76.00 g/L,platelet count 208.00 × 109/L,alanine aminotransferase 39.60 U/L,and aspartate aminotransferase 37.20 U/L.After 2 months of follow-up after discharge,the patient recovered well.
Babesia microtiFirst caseImported casesZhuhai City
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