Infectious Dz - Blood Borne 1 Flashcards
What type of parasite is Babesia?
an intra-erythroyctic protozoan parasite of the Apicomplexa phylum
What Babesia species infects dogs?
Babesia canis vogeli and Babesia gibsoni
Is Babesia canis vogeli a large or a small babesia species?
large
What is the vector for Babesia canis vogeli?
Brown dog tick
What breed of dog is predisposed to Babesia canis vogeli infection?
Greyhounds
What breed is predisposed to Babesia gibsoni infection?
American Pit Bull Terrier
Is Babesia gibsoni a large or small Babesia species?
small Babesia species
What Babesia species affect cats?
Babesia felis, Babesia cati, and Babesia leo
How is Babesia transmitted?
Tick vectors, fighting, congenital transplacental transmission, and blood transfusions
Is Babesiosis acute or chronic? Uncomplicated or severe?
all of the above
What clinical signs are associated with uncomplicated Babesiosis?
Anorexia, lethargy, weakness, pyrexia, and weight loss
Sometimes - jaundice, mucosal pallor, and urine discoloration
What disease processes are associated with uncomplicated Babesiosis?
Thrombocytopenia and anemia
What type of thrombocytopenia do Babesia infected patients have?
Immune-mediated thrombocytopenia - do not bleed in this condition
What types of anemia can Babesia infected patients get?
Regenerative, hemolytic, and immune-mediated
What causes the anemia in patients infected with Babesia?
Direct RBC injury by the Babesia parasites
What are the clinical features of severe Babesiosis?
Severe sepsis-like syndrome with multiple organ dysfunction
Acute renal failure
Neurologic Complications
DIC
Acute respiratory distress syndrome
What will a CBC show in patients with Babesiosis?
Thrombocytopenia, regenerative anemia, +/- autoagglutination, Coombs’ positive, and spherocytes
What will a chemistry panel show in patients with Babesiosis?
Nothing pathognomanic - hyperglobulinemia and mildly increased liver enzymes
What will a urinalysis show in Babesiosis patients?
Variable - Bilirubinuria, hemoglobinuria, and proteinuria
What is the best way to diagnose Babesia?
A combination of microscopy, serology, and PCR
What is the specificity and sensitivity of Cytology for Babesiosis?
highly specific, but not very sensitive
What is the serology test do you do in Babesia patients? Why might it not be beneficial as a test alone?
Immunofluorescent antibody assays (IFA) on serum
Not all dogs will have an antibody response, especially early in disease
What is the most sensitive test that can be done do diagnose Babesia?
PCR
What is the treatment of choice for Babesia canis vogeli?
Imidocarb diproprionate
What is the most effective treatment for Babesia gibsoni?
Atovaquone and azithromycin
What supportive care is given patients with Babesiosis?
Packed red blood cell transfusion, intravenous crystalloid fluids, +/- glucocorticoids
What is the prognosis for Babesiosis?
good with early diagnosis and appropriate treatment
How is Babesiosis prevented?
Tick control, prevent dog fighting, and screen your blood donors with serology and PCR
A 4 year FS Pit Bull presents to you with a week long history of anorexia and lethargy. Her physical exam is unremarkable other than a palpable spleen. CBC shows a moderate thrombocytopenia, but is otherwise normal. You think you see red cell inclusions that remind you of Babesia that you saw in your VCS 444 lectures. You think:
a. This cannot be Babesia as she is not anemic
b. You are ready to treat her for Babesia as the treatment for Babesia is the same regardless of the infecting Babesia species
c. It would be prudent to send off blood for Babesia PCR and to test for other vector borne disease that she could be co-infected with
d. You better have a heart to heart talk with the owners as most Babesia infections in the US progress to severe form that is almost always fatal.
c. It would be prudent to send off blood for Babesia PCR and to test for other vector borne disease that she could be co-infected with
13 YO MC Pit bull with dark colored urine. He was diagnosed with a UTI and prescribed enrofloxacin. The next day he was very weak and diagnosed with anemia.
Based on the breed and blood smear, what do you think Boz is infected with?
a. Babesia canis
b. Babesia gibsoni
b. Babesia gibsoni
13 YO MC Pit bull with dark colored urine. He was diagnosed with a UTI and prescribed enrofloxacin. The next day he was very weak and diagnosed with anemia. You have done a blood smear already and suspect that it is Babesia gibsoni. What test do you want to perform next?
a. Babesia serology
b. Babesia PCR
b. Babesia PCR
13 YO MC Pit bull with dark colored urine. He was diagnosed with a UTI and prescribed enrofloxacin. The next day he was very weak and diagnosed with anemia. You have done a blood smear already and suspect that it is Babesia gibsoni. You do a PCR and confirm your suspicion. How do you want to treat him?
a. Imidocarb
b. Atovaquone and azithromycin
b. Atovaquone and azithromycin
What is the etiologic agent of Cytauxzoonosis?
Cytauxzoon felis - a hemoprotozoan parasite of the phylum apicomplexa
In very general terms, what is Cytauxzoonosis?
A life threatening acute febrile illness of cats
What appears to be the reservoir host of Cytauxzoon felis?
Bobcats
What are the two forms of the pathogen Cytauxzoon felis?
Non-erythrocytic and erythrocytic
During what phase of the Cytauxzoon felis lifecycle does acute illness occur?
schizogenous phase
What clinical signs are associated with Cytauxzoonosis?
Acute onset of lethargy and anorexia in a previously healthy cat
Tachypnea, dyspnea, icterus, vocalization, elevated 3rd eyelid
What will you find on physical exam in patients with Cytauxzoonosis?
Fever, icterus, pallor, elevated 3rd eyelid, tachycardia, tachypnea, splenomegaly, hepatomegaly, and lymphadenomegaly
What will the CBC show in patients with Cytauxzoonosis?
Pancytopenia or bicytopenia, Leukopenia, neutropenia, lymphopenia, and thrombocytopenia
See a neutrophilia with bands
Hemolytic anemia days 7-14 after presentation
What will the chemistry panel show in patients with Cytauxzoonosis?
nothing specific, hyperbilirubinemia from hepatic vascular occlusion and/or hemolysis, mild to moderate ALT and ALP elevation
What will you find on UA in patients with Cytauxzoonosis?
Bilirubinuria
What will you see on the coagulation panel in patients with Cytauxzoonosis?
Prolonged aPTT and PT (DIC)
How do you diagnose Cytauxzoonosis?
Cytology, PCR, and serology
What can you ID in a cytology that will confirm acute cytauxzoonosis?
Schizont laden mononuclear cells
What structure on cytology cannot confirm cytauxzoon illness?
Piroplasms
What is the most sensitive test for Cytauxzoon felis?
PCR
Why is serology not recommended for diagnosis of Cytauzoonosis?
Because illness precedes antibody formation
How is Cytauxzoonosis treated?
Atovaquone, Azithromycin, and supportive care
What supportive care is given to patients with Cytauxzoonosis?
Crystalloid fluids, blood transfusions, plasma transfusion, heparin, possibly pain management, and a feeding tube
What is the survival rate of patients with Cytauxzoonosis when treated with atovaquppne ,azithromycin and aggressive supportive care?
85%
What complication is most likely to be associated with felne cytuaxzoonosis?
Disseminated intravascular coagulation
