一例复发犬吉氏巴贝斯虫病复杂感染的多轮治疗与体会

A Multistage Treatment Experience and Insights into a Complicated Case of Relapsing Canine Babesiosis gibsoni

摘要: 文章详细报告了一例体重3.7公斤贵宾犬复发性吉氏巴贝斯虫病的复杂诊疗过程。该犬首次就诊表现为严重溶血性贫血，采用一线“金标准”阿托伐醌联合阿奇霉素方案治疗后临床症状短暂缓解，但实时荧光定量PCR (qPCR)检测持续阳性，治疗失败。随后更换为二线贝尼尔(三氮脒)治疗，虽迅速改善血常规指标达到“临床治愈”，但约6周后复发，qPCR再次转阳。最终，启用长达13周的克林霉素–多西环素–甲硝唑三联长程疗法，该方案以免疫调节为核心机制，成功使患犬临床症状消失，血液学指标恢复正常，并在治疗结束时及长期随访中qPCR持续阴性，达到寄生虫学治愈。本病例表明，对于顽固性、复发性吉氏巴贝斯虫感染，需建立“诊断–治疗–动态监测–方案调整”的管理闭环。其中，qPCR是疗效评估的关键依据，个体化的序列治疗策略结合终身综合防控则是治疗成功的关键。

Abstract: This article details the complex diagnosis and treatment process of a relapsing Babesia gibsoni infection in a 3.7 kg Toy Poodle. The dog initially presented with severe hemolytic anemia. First-line “gold standard” therapy with atovaquone and azithromycin resulted in only transient clinical improvement, with real-time quantitative PCR (qPCR) remaining positive, indicating treatment failure. Subsequent second-line therapy with diminazene aceturate (Berenil) rapidly improved hematological parameters, achieving “clinical cure”, but relapse occurred approximately 6 weeks later, with qPCR turning positive again. Ultimately, a prolonged 13-week course of triple therapy with clindamycin, doxycycline, and metronidazole was initiated. This regimen, centered on immunomodulation, successfully resolved clinical signs, normalized hematological parameters, and resulted in sustained negative qPCR results at the end of treatment and during long-term follow-up, achieving parasitological cure. This case demonstrates that for refractory, relapsing Babesia gibsoni infection, it is essential to establish a management loop of “diagnosis-treatment-dynamic monitoring-protocol adjustment”. qPCR is crucial for efficacy evaluation, and a personalized sequential treatment strategy combined with lifelong comprehensive prevention and control is key to success.