Co-infection of babesiosis and ehrlichiosis: a case in Cartagena de Indias, Colombia

Introduction: there are multiple entities that are transmitted by ticks; one of them isthe babesiosis, an entity that is produced by species of hemoparasites that produce,in the human host, hemolysis due to the parasitic invasion. Other of the entities is taquicártheehrlichiosis, which is characterized by the infection of intracellular microorganismswhose symptoms are part of the spectrum of a fever pattern.Clinical case: patient from rural area, with history of exposure to ixodoidea (ticks)in a permanent way. Who is admitted with signs of systemic inflammatory response,constitutional symptoms and fever of evening predominance. Hepatomegaly andadenomegalies in supraclavicular area were found. With clinical impression of prolongedfever pattern and hemolytic anemia; it was asked for spread of peripheral blood forhemoparasites. Positive report for two species: Babesia spp. and Ehrlichia spp whichwere visualized by Wright-Giemsa stain. It is carried out treatment with doxycycline,clindamycin and quinine, with good clinical aspects. Without any complications.Conclusions: this is the first case of co-infection that is known in the ColombianCaribbean region, the diagnosis was suspected due to the importance that was givento the epidemiological antecedents, to the history of exposure to ixodoidea and to theclinical symptoms of persistent fever syndrome. It was done under microscopy techniqueby Wright-Giemsa stain and the result after the conjugated antibiotic treatment wassuccessful. Rev.Cienc.Biomed. 2012;3(2):339-345.RESUMEN:Introducción: múltiples son las entidades transmitidas por garrapatas, una de ellases la babesiosis, entidad producida por especies de hemoparásitos que producen en elhuésped humano hemolisis secundaria a la invasión parasitaria. Otra de las entidadeses la ehrlichiosis, caracterizada por la infección de microorganismos intracelulares cuyossíntomas hacen parte del espectro de un cuadro febril.Caso clínico: paciente procedente de área rural, con historia de exposición aixodoideos (garrapatas) de forma permanente. Ingresa cursando signos de respuestainflamatoria sistémica, síntomas constitucionales y fiebre de predominio vespertino.Hepatomegalia y adenomegalias en región supraclavicular. Con impresión clínica decuadro febril prolongado y anemia hemolítica, se solicita extendido de sangre periféricapara hemoparásitos. Reporte positivo para dos especies: Babesia spp. y Ehrlichiaspp., fueron visualizadas por tinción de Giemsa-Whright. Se realizó tratamiento condoxiciclina, clindamicina y quinina, con buena evolución clínica. No se presentaronco