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Clinicalkey AI in action: What are indications for plasma exchange in severe babesiosis

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ClinicalKey AI Query: What are indications for plasma exchange in severe babesiosis

Plasma exchange, also known as exchange blood transfusion, is indicated in severe babesiosis in cases of high-grade parasitemia (10% or more of erythrocytes), severe hemolytic anemia (less than 10 g/dL), pulmonary, renal, or hepatic impairment, and Babesia divergens infection.[1-2]

  • Exchange blood transfusion is used to rapidly decrease parasite burden and clear toxic byproducts from circulation.[1]

  • The procedure can be either partial or complete, depending on the severity of the disease.[1]

  • It is capable of reducing parasitemia by 90%, and limited data suggest early use (within approximately 1.5 days after presentation) of exchange transfusion may prevent organ dysfunction.[1]

  • In addition to antibiotic treatment, partial or complete red cell exchange transfusion should be considered in severely ill patients with parasitemias in excess of 10%, evidence of severe hemolysis, or organ compromise.[3]

  • A systematic review suggests that apheresis may be a useful adjunct in the treatment of patients hospitalized for babesiosis.[4]

  1. Babesiosis.opens in new tab/window  Elsevier ClinicalKey  Clinical Overview 

  2. Babesiosis (Babesia).opens in new tab/window  Krause, Peter J.  Book Chapter 

  3. Babesiosis and Other Protozoan Diseases.opens in new tab/window  Telford, Sam R., Krause, Peter J. In Goldman-Cecil Medicine (pp. 2151). 

  4. Safety and Effectiveness of Apheresis in the Treatment of Infectious Diseases: A Systematic Review.opens in new tab/window  Odedra A, Lalloo DG, Kennedy G, Llewellyn S, McCarthy JS.  The Journal of Infection. 2019;79(6):513-520. doi:10.1016/j.jinf.2019.09.014. 

Answer generated on April 2, 2024 

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