Coinfección de babesiosis y ehrlichiosis: un caso en Cartagena de indias, Colombia

Juan Montes Farah, Fernando De la Vega del Risco, Ariel Bello Espinosa, Adriana Sofía Fortich Salvador

DOI: https://doi.org/10.32997/rcb-2012-3132

Resumen

Introducción: múltiples son las entidades transmitidas por garrapatas, una de ellas es la babesiosis, entidad producida por especies de hemoparásitos que producen en el huésped humano hemolisis secundaria a la invasión parasitaria. Otra de las entidades es la ehrlichiosis, caracterizada por la infección de microorganismos intracelulares cuyos síntomas hacen parte del espectro de un cuadro febril.
Caso clínico: paciente procedente de área rural, con historia de exposición a ixodoideos (garrapatas) de forma permanente. Ingresa cursando signos de respuesta inflamatoria sistémica, síntomas constitucionales y fiebre de predominio vespertino.
Hepatomegalia y adenomegalias en región supraclavicular. Con impresión clínica de cuadro febril prolongado y anemia hemolítica, se solicita extendido de sangre periférica para hemoparásitos. Reporte positivo para dos especies: Babesia spp. y Ehrlichia spp., fueron visualizadas por tinción de Giemsa-Whright. Se realizó tratamiento con doxiciclina, clindamicina y quinina, con buena evolución clínica. No se presentaron complicaciones.
Conclusiones: este es el primer caso de coinfección conocido de la región Caribe colombiana. El diagnóstico se sospechó debido a la importancia dada a los antecedentes epidemiológicos, a la historia de exposición a ixódidos y a la clínica de síndrome febril persistente. Este, se realizó bajo técnica de microscopía por tinción de Wrihgt-Giemsa y el resultado, tras el tratamiento antibiótico conjugado, fue exitoso. Rev.Cienc.Biomed. 2012;3(2): 339-345


Palabras clave

Hemoparásitos; Coinfección; Babesia spp.; Ehrlichia spp.; Fiebre.

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