Treatment of refractory Babesia microti infection with atovaquone-proguanil in an HIV-infected patient: case report.

Abstract

A patient with acquired immune deficiency syndrome presented with babesiosis 6 months after presumed tick exposure. Despite initial treatment with azithromycin and atovaquone, followed by quinine and clindamycin, he experienced an increasing parasite load. Finally, red blood cell exchange transfusion, anti-Babesia therapy, and the addition of atovaquone-proguanil to the treatment regimen led to symptomatic improvement and elimination of parasitemia. Low-level parasitemia recurred 20 weeks later and was eradicated by administration of atovaquone-proguanil monotherapy. Atovaquone-proguanil appears to have activity against babesiosis and should be studied as a potential therapy for patients with refractory babesiosis.

• Authors: Jatin M Vyas, Sam R Telford, Gregory K Robbins
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 45 Issue 12 Pg. 1588-90 (Dec 15 2007) ISSN: 1537-6591 [Electronic] United States
• PMID: 18190320 (Publication Type: Case Reports, Journal Article)

Chemical References

• Drug Combinations
• atovaquone, proguanil drug combination
• Proguanil
• Atovaquone

Topics

• Acquired Immunodeficiency Syndrome (complications, immunology)
• Animals
• Atovaquone (administration & dosage, therapeutic use)
• Babesia microti
• Babesiosis (complications, diagnosis, drug therapy)
• Drug Combinations
• Humans
• Immunocompromised Host
• Male
• Middle Aged
• Proguanil (administration & dosage, therapeutic use)