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Babesiosis

A tick-borne disease caused by the Babesia genus of protozoa (single cell parasite).  Babesiosis is mainly a disease of animals; it can affect horses, sheep, cattle and other domestic animals.  However babesiosis can be transmitted from animals to humans by tick bites producing symptoms similar to those of malaria.

Anti malarial drug, quinine is used to treat this.  It is antibiotic drug. 

fever, chills, confusion, weakness, sweating;

severe vomiting, stomach pain, diarrhea;

problems with vision or hearing;

severe flushing (warmth, redness, or tingly feeling);

urinating less than usual or not at all;

;easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

blood in your urine or stools;

weak or shallow breathing, feeling like you might pass out

fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or

loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

headache, blurred vision, changes in color vision;

mild dizziness, spinning sensation, ringing in your ears;

upset stomach; or

muscle weakness chest pain, trouble breathing, severe dizziness, fainting, fast or pounding heartbeats; fever, chills, confusion, weakness, sweating;

Other side effects have included mucosal bleeding (gingival, gastrointestinal, epistaxis

.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Gastrointestinal

abdominal pain, nausea, vomiting, diarrhea, and gastrointestinal upset. Are some of the Gastrointestinal side effects

 

Applies to quinine: oral capsule, oral tablet compounding powder, oral capsule

Hematologic

a 79-year-old female within 12 hours following a second dose of quinine 300 mg reported Disseminated intravascular coagulation has been reported in

thrombocytopenia, ecchymosis  neutropenia, thrombotic thrombocytopenic purpura-hemolytic uremic syndrome, disseminated intravascular coagulation, petechiae, and purpura. At least 7 cases of immune thrombocytopenia are some of the Hematologic side ffects thaten reported.

Dermatologic

flushing, pruritus, and skin rashes. Fixed drug eruption (nummular skin lesion) and fatal cutaneous vasculitis  Dermatologic side effects.

Fixed drug eruption (nummular skin lesion) has been reported in a 23-year-old female following exposure to quinine in tonic water. An open oral challenge, approved by the patient, with 30 mg quinine sulfate triggered the appearance of pruritus, erythema, and edema at the usual sites within 40 minutes of ingestion of the dose.

Renal

Renal failure secondary to thrombotic thrombocytopenic purpura-hemolytic uremic syndrome are some of the renal side effects

Respiratory

Asthma symptoms, hemoptysis, and a case report of transient bilateral pulmonary infiltrates are some of the respiratory side effects

A 45-year-old woman complained of particular symptoms following a single dose of quinine sulfate 325 mg and they were nocturnal cramps. Approximately 45 minutes after she took the single dose of quinine the following symptoms were present: Transient bilateral pulmonary infiltrates, sudden onset of dyspnea, severe anxiety, dry nonproductive cough, orthopnea, mild fever, chills, and pleuritic chest discomfort, wheezing, cough, breathlessness,

Ocular

Ocular side effects have included visual disturbances including blurred vision with scotomata, photophobia, diplopia, diminished visual fields, disturbed color vision, and blindness.

Cardiovascular

Cardiovascular side effects have included cardiac dysrhythmias, including prolongation of the QT-interval.

Hepatic

Hepatic side effects have included changes in the hepatic enzyme system that synthesizes vitamin K dependent factors. At least one case report of hepatotoxicity with elevated alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltranspeptidase has been reported.

, generalized myalgia, headache, fever, chills, and rigor. The following liver enzymes were dramatically elevated: alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltranspeptidase. Following discontinuation of quinine, the patient's symptoms resolved within 48 hours and the liver enzyme concentrations declined within 72 hours. Within 24 hours of taking the first dose of quinine 260 mg for leg cramps, a 57-year-old Native American female presented to the hospital with symptoms of nausea, vomiting

Nervous system

Nervous system side effects have included apprehension, restlessness, confusion, syncope, dizziness, vertigo, tinnitus, hearing loss, and nystagmus. Cinchonism has been reported with repeated doses or high serum levels in 25% to 100% of patients. Signs and symptoms of cinchonism have been commonly reported. The clinical presentation of cinchonism have included temporary deafness/slight deafness, tinnitus, headache, dizziness, rash, mental dullness, depression, confusion, and nausea. Fatalities have been reported from single oral doses of 2 to 8 grams.

Tinnitus and impaired hearing may occur at plasma concentrations over 10 mcg/mL.

Hypersensitivity

Hypersensitivity side effects have been reported in a few patients who experienced severe side effects after a single dose of quinine.

Metabolic

Metabolic side effects have included hypoglycemia and electrolyte imbalance.

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