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Babesiosis

Babesiases

Babesiosis is an infectious tick-borne caused by protozoa of the genus Babesia.


Presentation

The symptoms manifested in cases of babesiosis are similar to symptoms of malaria. The extent of the symptoms depends on the extent of RBC destruction due to the parasite. The range can be from no overt symptoms to severe haemolysis which can be fatal. The affected patients may give a history of travel to the endemic areas. In patients with subclinical infection, there may be spontaneous development of the symptoms after splenectomy or after immunosuppressive therapy. Patients who are healthy and have a strong immune system, may remain asymptomatic or may suffer from mild to moderate symptoms.

The incubation period for patients bitten by the infected tick is about one to four weeks, while the incubation period for patients affected due to contaminated blood transfusion is about one week to six months. The most common symptoms include high grade fever ranging up to 40.9 °C (105.6 °F). In a study of 139 patients of babesiosis hospitalised at New York, the commonest symptoms noted were – fatigue/malaise/weakness (91%), fever (91%), shaking chills (77%), diaphoresis (69%) [6]. Splenomegaly is also detected. Along with fever there is severe malaise, fatigue, severe chills, sweating, anorexia, nausea, vomiting, weight loss, headache, myalgia, arthralgia, cough, sore throat, photophobia and depression. Haemoglobinuria is also one of the accompanying symptoms. The fatigue continues for several months even after other symptoms have subsided.
Immuno-suppressed patients, patients with HIV infection, the elderly patients and who have undergone splenectomy suffer from more severe and prolonged infections with relapses needing frequent hospitalisation.

Complications

The patients can experience certain complications which include disseminated intravascular coagulopathy and acute respiratory distress syndrome. Other complications may include liver, kidney or congestive heart failure, coma and death. Asplenic patients have a more prolonged disease course, higher morbidity and mortality and more overwhelming infection [7]. Shock, relapse and spontaneous splenic rupture too have been observed [8].

Splenomegaly
  • Intraoperatively, the patient was noted to have splenomegaly. Postoperatively, she developed fever and was found to have Babesia microti on blood smear with an otherwise negative fever evaluation.[ncbi.nlm.nih.gov]
  • Babesia infection Hemolytic anemia due to babesiosis Hemolytic anemia, babesiosis Clinical Information Tickborne disease caused by infection with protozoa; occurs in wild and domestic animals; in humans causes malaria-like symptoms, myalgia, nausea and splenomegaly[icd9data.com]
  • The most common symptoms are fever (that can reach up to 40.9 C and may be accompanied by splenomegaly), malaise and fatigue.[orpha.net]
  • Splenomegaly is also detected. Along with fever there is severe malaise, fatigue, severe chills, sweating, anorexia, nausea, vomiting, weight loss, headache, myalgia, arthralgia, cough, sore throat, photophobia and depression.[symptoma.com]
  • Definition (CSP) tickborne disease caused by infection with protozoa; occurs in wild and domestic animals; in humans causes malaria-like symptoms, myalgia, nausea and splenomegaly; classic zoonotic disease.[fpnotebook.com]
Fever
  • Postoperatively, she developed fever and was found to have Babesia microti on blood smear with an otherwise negative fever evaluation. She was treated with atovaquone and azithromycin and made a full recovery.[ncbi.nlm.nih.gov]
  • Fevers of unknown origin (FUOs) are defined as prolonged fevers of 101 degrees F or greater lasting 3 or more weeks that remain undiagnosed after comprehensive inpatient/outpatient laboratory testing.[ncbi.nlm.nih.gov]
  • A peripheral blood smear should be reviewed in any patient with a recent transfusion and a fever of unknown origin.[ncbi.nlm.nih.gov]
  • His fever subsided rapidly, and his hematocrit eventually returned to normal. A 34-year-old man came to the emergency room with a 3-day history of fevers (peak temperature, 40 C), accompanied by shaking chills.[doi.org]
  • The patient presented to his primary care physician with a history of intermittent fever and myalgias and was admitted to the hospital for investigation. On admission, he was found to have fever, left flank pain, and thrombocytopenia.[ncbi.nlm.nih.gov]
Anemia
  • The disease is caused by the protozoa of the genus Babesia, which invade human erythrocytes and lyse them causing a febrile hemolytic anemia.[ncbi.nlm.nih.gov]
  • The development of warm-antibody autoimmune hemolytic anemia (also known as warm autoimmune hemolytic anemia [WAHA]) in patients with babesiosis has not previously been well described.[ncbi.nlm.nih.gov]
  • RESULTS: A recipient of a living-related renal transplant developed acute postoperative hemolytic anemia. The etiology of this anemia was diagnosed by peripheral red blood cell smear as Babesia microti.[ncbi.nlm.nih.gov]
  • Convert to ICD-10-CM : 088.82 converts directly to: 2015/16 ICD-10-CM B60.0 Babesiosis Approximate Synonyms Babesia infection Hemolytic anemia due to babesiosis Hemolytic anemia, babesiosis Clinical Information Tickborne disease caused by infection with[icd9data.com]
  • Our experiences with this patient suggest that babesiosis should be considered in the differential diagnosis of transplant patients who have fever and hemolytic anemia.[ncbi.nlm.nih.gov]
Chills
  • This case emphasizes the need to consider tick-borne disease in anyone who presents with prolonged and undulating fevers, chills, headache, myalgias, and arthralgias.[ncbi.nlm.nih.gov]
  • ., and Elizabeth Broome, M.D. 6 Citing Articles A 34-year-old man came to the emergency room with a 3-day history of fevers (peak temperature, 40 C), accompanied by shaking chills.[doi.org]
  • Babesiosis presents clinically as a malaria-like illness with fever, chills, headache, fatigue with lymphopenia, atypical lymphocytes, mildly or transiently elevated serum transaminases, thrombocytopenia, and increased lactate dehydrogenase (LDH) levels[ncbi.nlm.nih.gov]
  • Patients were grouped according to their risk-factors for Babesia infection: (group 1) individuals with fever, chills, sweating and other malaria-type symptoms; (group 2) symptomatic and asymptomatic individuals from local cattle ranches, which were enrolled[ncbi.nlm.nih.gov]
  • Symptoms include high fever, chills, diaphoresis, weakness, anorexia and headache. Later in the course of the illness, the patient may develop jaundice.[ncbi.nlm.nih.gov]
Fatigue
  • Abstract An 85-year-old man, actively infected with Babesia microti and Ehrlichia chaffeensis, presented with fatigue and thrombocytopenia. He developed rhabdomyolysis and multiple organ failure, which led to death 6 days after initial presentation.[ncbi.nlm.nih.gov]
  • These range from mild fever, sweats, fatigue, and myalgias to severe multiorgan failure, including acute respiratory distress syndrome and death. Radiographic appearances include bilateral patchy air space and interstitial opacities.[ncbi.nlm.nih.gov]
  • Babesiosis presents clinically as a malaria-like illness with fever, chills, headache, fatigue with lymphopenia, atypical lymphocytes, mildly or transiently elevated serum transaminases, thrombocytopenia, and increased lactate dehydrogenase (LDH) levels[ncbi.nlm.nih.gov]
  • The most common symptoms are fever (that can reach up to 40.9 C and may be accompanied by splenomegaly), malaise and fatigue.[orpha.net]
  • Along with fever there is severe malaise, fatigue, severe chills, sweating, anorexia, nausea, vomiting, weight loss, headache, myalgia, arthralgia, cough, sore throat, photophobia and depression.[symptoma.com]
Splenectomy
  • The third patient underwent splenectomy for trauma and acquired babesiosis postoperatively from a blood transfusion. Our cases demonstrate the need to be vigilant for babesiosis in patients undergoing splenectomy.[ncbi.nlm.nih.gov]
  • To our knowledge, this is the first reported case treated without splenectomy. Our successful experience suggests conservative management may be appropriate for some patients.[ncbi.nlm.nih.gov]
  • Patients undergoing splenectomy in an endemic area should be screened for babesiosis to prevent postoperative recrudescence of symptoms.[ncbi.nlm.nih.gov]
  • The second patient had a history of ES requiring splenectomy, which relapsed after Babesia infection. The complex presentation and medical histories of both patients made the diagnosis challenging.[ncbi.nlm.nih.gov]
  • A 73-year-old man who had had a splenectomy and had a fatal case of babesiosis.[ncbi.nlm.nih.gov]
Nausea
  • This is a case of a 71-year-old homosexual man who presented with a 4-day history of fever, weakness and headaches, near syncope, nausea and poor oral intake.[ncbi.nlm.nih.gov]
  • A 66-year-old splenectomized man was admitted to a Lisbon hospital after 1 week of fever, abdominal pain, anorexia and nausea.[ncbi.nlm.nih.gov]
  • Synonyms Babesia infection Hemolytic anemia due to babesiosis Hemolytic anemia, babesiosis Clinical Information Tickborne disease caused by infection with protozoa; occurs in wild and domestic animals; in humans causes malaria-like symptoms, myalgia, nausea[icd9data.com]
  • Nausea or vomiting ( P 0.01) and diarrhea ( P 0.01) along with hyperbilirubinemia ( P 0.01) were predictive of severe infection, hospitalization, and prolonged antimicrobial therapy.[ncbi.nlm.nih.gov]
  • When symptoms do occur, they typically begin one to four weeks after the tick bite and can include fever, chills, sweats, headache, body aches, loss of appetite, nausea, or fatigue.[healthvermont.gov]
Vomiting
  • Nausea or vomiting ( P 0.01) and diarrhea ( P 0.01) along with hyperbilirubinemia ( P 0.01) were predictive of severe infection, hospitalization, and prolonged antimicrobial therapy.[ncbi.nlm.nih.gov]
  • Less frequently, some may experience sore throat, photophobia, vomiting, weight loss and depression. Symptoms can last 1-2 weeks but fatigue may persist for several months.[orpha.net]
  • Along with fever there is severe malaise, fatigue, severe chills, sweating, anorexia, nausea, vomiting, weight loss, headache, myalgia, arthralgia, cough, sore throat, photophobia and depression.[symptoma.com]
  • Nausea, vomiting, headache, shaking chills, blood in the urine, and depression can occur.[encyclopedia.com]
  • The incubation period varies from 2 to 6 weeks and is followed by sudden onset of chills and fever, sometimes with muscle aches and pains, prostration, jaundice, dark urine, diarrhea, and vomiting.[histopathology-india.net]
Abdominal Pain
  • A 66-year-old splenectomized man was admitted to a Lisbon hospital after 1 week of fever, abdominal pain, anorexia and nausea.[ncbi.nlm.nih.gov]
  • If symptoms occur, they may include fever, chills, headache, achy joints and muscles, fatigue, nausea, vomiting, abdominal pain and dark urine. Symptoms can last for up to several months.[mass.gov]
  • Dark urine TABLE 1 Common Presenting Signs and Symptoms of Human Babesiosis Generalized weakness Fever Gastrointestinal symptoms (anorexia, nausea, abdominal pain, vomiting, diarrhea, etc.)[aafp.org]
  • pain, emotional liability, „mental dullness”, kidney problems, influenza-like symptoms.[arminlabs.com]
  • Affected individuals may also have additional symptoms including nausea, vomiting, and/or abdominal pain. In some cases, an abnormally large liver and or spleen (hepatosplenomegaly) may be present.[rarediseases.org]
Jaundice
  • Jaundice, hepatosplenomegaly, anemia and conjugated hyperbilirubinemia developed in this preterm infant. The diagnosis was eventually made by blood smear, serology and polymerase chain reaction.[ncbi.nlm.nih.gov]
  • During hospitalization, the patient developed pancytopenia and jaundice and became progressively more ill. A serendipitous conversation led to the investigation into babesiosis and empiric treatment.[ncbi.nlm.nih.gov]
  • Later in the course of the illness, the patient may develop jaundice. Congestive heart failure, renal failure and acute respiratory distress syndrome are the most common complications.[ncbi.nlm.nih.gov]
  • Prolonged cases may show signs of anaemia and jaundice. Light-red to dark-red discolouration of the urine is often seen. The spleen is enlarged, sometimes several times its normal size, and the cut surface resembles raspberry jam.[web.archive.org]
  • Babesiosis can also cause a particular type of anemia, which makes a person develop jaundice (yellowing of the skin) and have dark urine.[healthvermont.gov]
Hepatomegaly
  • On physical examination, fever, splenomegaly, hepatomegaly, or jaundice may be observed.[aldf.com]
  • Physical examination may reveal hepatomegaly and splenomegaly or evidence of shock.[aafp.org]
Hepatosplenomegaly
  • Jaundice, hepatosplenomegaly, anemia and conjugated hyperbilirubinemia developed in this preterm infant. The diagnosis was eventually made by blood smear, serology and polymerase chain reaction.[ncbi.nlm.nih.gov]
  • Manifestations of disease include fever, chills, sweating, myalgias, fatigue, hepatosplenomegaly, and hemolytic anemia. Symptoms typically occur after an incubation period of 1 to 4 weeks, and can last several weeks.[cdc.gov]
  • The signs and symptoms include fever , chills, sweating, myalgias (muscle aches), fatigue , hepatosplenomegaly (enlargement of the liver and spleen) and hemolytic anemia (anemia due to break-up of red cells).[medicinenet.com]
  • In some cases, an abnormally large liver and or spleen (hepatosplenomegaly) may be present.[rarediseases.org]
Petechiae
  • Petechiae (small red or purple spots due to bleeding into the skin) and bruises may occur, most likely due to thrombocytopenia (low platelets, which causes abnormal blood clotting).[dermnetnz.org]
Myalgia
  • This case emphasizes the need to consider tick-borne disease in anyone who presents with prolonged and undulating fevers, chills, headache, myalgias, and arthralgias.[ncbi.nlm.nih.gov]
  • These range from mild fever, sweats, fatigue, and myalgias to severe multiorgan failure, including acute respiratory distress syndrome and death. Radiographic appearances include bilateral patchy air space and interstitial opacities.[ncbi.nlm.nih.gov]
  • The patient presented to his primary care physician with a history of intermittent fever and myalgias and was admitted to the hospital for investigation. On admission, he was found to have fever, left flank pain, and thrombocytopenia.[ncbi.nlm.nih.gov]
  • Approximate Synonyms Babesia infection Hemolytic anemia due to babesiosis Hemolytic anemia, babesiosis Clinical Information Tickborne disease caused by infection with protozoa; occurs in wild and domestic animals; in humans causes malaria-like symptoms, myalgia[icd9data.com]
  • Other common manifestations include chills, sweats, headache, myalgia, arthralgia, nonproductive cough, nausea, and anorexia. Less frequently, some may experience sore throat, photophobia, vomiting, weight loss and depression.[orpha.net]
Emotional Lability
  • Rash is an uncommon symptom in babesiosis. 1, 2, 3, 7 Signs of central nervous system involvement include headache, photophobia, neck and back stiffness, altered sensorium and emotional lability. 3, 7, 15 View/Print Table TABLE 1 Common Presenting Signs[aafp.org]
Headache
  • This case emphasizes the need to consider tick-borne disease in anyone who presents with prolonged and undulating fevers, chills, headache, myalgias, and arthralgias.[ncbi.nlm.nih.gov]
  • Evaluation by obstetrics, primary care, and neurology over 4 weeks yielded diagnoses of Lyme disease, upper respiratory infection, migraine, and medication overuse headache. Babesiosis was diagnosed only after she became acutely ill with hemolysis.[ncbi.nlm.nih.gov]
  • Although headache and lethargy are common symptoms, babesiosis is uncommonly associated with specific neurological dysfunction in humans.[ncbi.nlm.nih.gov]
  • This is a case of a 71-year-old homosexual man who presented with a 4-day history of fever, weakness and headaches, near syncope, nausea and poor oral intake.[ncbi.nlm.nih.gov]
  • Babesiosis presents clinically as a malaria-like illness with fever, chills, headache, fatigue with lymphopenia, atypical lymphocytes, mildly or transiently elevated serum transaminases, thrombocytopenia, and increased lactate dehydrogenase (LDH) levels[ncbi.nlm.nih.gov]
Dark Urine
  • After treatment with a chimeric anti-CD20 antibody preparation (Rituximab), the patient was hospitalised because of anaemia and dark urine from haemoglobinuria.[ncbi.nlm.nih.gov]
  • Babesiosis can also cause a particular type of anemia, which makes a person develop jaundice (yellowing of the skin) and have dark urine.[healthvermont.gov]
  • Common symptoms include extreme fatigue, aches, fever, chills, sweating, dark urine, and possibly anemia.[maine.gov]
  • This type of anemia can lead to jaundice (yellow-colored skin) and dark urine.[capemaycountynj.gov]
Kidney Failure
  • Complications include very low blood pressure, liver problems, severe hemolytic anemia (a breakdown of red blood cells), and kidney failure. Babesiosis Diagnosis and Treatment Sometimes, babesia can be detected in blood examined under a microscope.[lymedisease.org]
  • failure The goals of diagnostic testing are to identify a Babesia infection or to rule out babesiosis as the cause of symptoms.[labtestsonline.org]

Workup

One must suspect babesiosis infection in patients with fever of unknown origin who reside in or have recently travelled to or from an endemic area or who have recently received a blood transfusion. The diagnosis detection depends on the extent of the infection and on the skills of the laboratory technician.

In patients who are asymptomatic the laboratory findings may not be conclusive. Laboratory testing includes a complete blood count (CBC). It may reveal haemolytic anaemia, lymphopenia, and thrombocytopenia. The erythrocyte sedimentation rate (ESR) may be increased.

Peripheral blood smears can be used to diagnose Babesiosis by microscopic examination of Giemsa-stained or Wright-stained blood smears which reveal the different forms of parasites in the RBCs. In patients suffering from an asymptomatic infection, the smear results may not be positive.

Serum chemistry shows elevated levels of serum creatinine and blood urea nitrogen. Liver function tests (LFTs) show elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatise. It also reveals high bilirubin levels and reduced haptoglobin level1. Elevated Lactate dehydrogenase (LDH) levels reveal the extent of the severity of the infection.

Serological testing which includes Indirect immunofluorescent Antibody (IFA) assay of immunoglobulin M (IgM) or immunoglobulin G (IgG) can also be useful in confirming the diagnosis. However, Immunoblot antibody testing has greater sensitivity and specificity as compared to IFA testing.

Hamster inoculation includes intraperitoneal inoculation of Ethylene Diamine Tertraacetic Acid (EDTA) whole blood from the patient into the peritoneum of a hamster followed by antibody analysis of the animal blood. This test helps in diagnosis when above mentioned tests are non-conclusive.

Polymerase chain reaction (PCR) can help in confirming the diagnosis by detecting Babesia DNA in the patient's blood. A study found that PCR could detect babesial DNA as late as 27 months after an untreated infection [9]. PCR testing is more specific as compared with peripheral smear evaluation and hamster inoculation.

Urinalysis may reveal haemoglobinuria.

In cases of complications like acute respiratory distress syndrome or pneumonias, chest radiographs must be taken.

Hematocrit Decreased
  • These include: Decreased red blood cells, hemoglobin and hematocrit Decreased platelet numbers (thrombocytopenia) Normal or slightly decreased white blood cell count Comprehensive metabolic panel (CMP) —the tests included in this panel are used to determine[labtestsonline.org]
Cytopenia
  • Here we present two cases of severe cytopenias in asplenic patients precipitated by active babesiosis.[ncbi.nlm.nih.gov]
Babesia Microti
  • Postoperatively, she developed fever and was found to have Babesia microti on blood smear with an otherwise negative fever evaluation. She was treated with atovaquone and azithromycin and made a full recovery.[ncbi.nlm.nih.gov]
  • METHODS: We briefly review these zoonoses and present a case of a renal transplant recipient who survived infection by Babesia microti contracted through blood transfusion.[ncbi.nlm.nih.gov]
  • METHODS: In the spring of 2013, we conducted a point-in-time survey of Ixodes scopuloris ticks for the presence of Babesia microti.[ncbi.nlm.nih.gov]
  • KEYWORDS: Babesia microti; Borrelia burgdorferi; Connecticut; Ixodes scapularis; Lyme disease; Massachusetts; New England; emergence; human babesiosis; incidence ratio; infection prevalence; parasites; piroplasm; tick-borne pathogens[ncbi.nlm.nih.gov]
  • KEYWORDS: Alanine aminotransferase; Aspartate aminotransferase; Babesia microti; Babesiosis; Diagnostic test; Molecular beacons[ncbi.nlm.nih.gov]

Treatment

The goal of medical therapy is to reduce morbidity and mortality, eradicate infection and prevent sequelae. Antimicrobial agents like atovaquone and azithromycin are administered to treat mild to moderate infection of babesiosis.

In a prospective study, it was noted that atovaquone plus azithromycin are as effective as clindamycin plus quinine in giving clinical relief and reducing parasitemia [10]. Treatment of severe infection includes oral quinine and intravenous clindamycin.

Doxycycline too has been used along with clindamycin and azithromycin in patients who were allergic to cinchone derived quinine. Parasitemia may continue to persist even after treatment with either drug regimen.

Complete or partial blood transfusion may be indicated in patients with severe infection. Repetition of the oral therapy may be required in patients who are immune-compromised or asplenic patients.

Prognosis

The prognosis of the disease is dependent on the species of the parasite and the general immune status of the patient. Most patients with a strong immune system have excellent recovery.

Etiology

Parasites of the genus Babesia cause the disease Babesiosis. It is an illness which is spread from animals to humans hence, called a zoonotic disease. The parasite is transmitted through a tick bite.

Animals that act as reservoirs are horses, cattle and cats. Such cases have often been reported where the blood donor resided or travelled to an endemic area [3] [4]. The protozoan can easily be transmitted through transfusion of contaminated blood or blood products. Very rarely, it can be transmitted through the placenta from an infected mother to the foetus.

Epidemiology

Prevalence of Babesiosis all over the world is not clearly known. It is commonly reported in The United States of America. Babesiosis is less common in other areas of the world like in Europe, Asia, Africa, Australia etc.

Since most patients who are infected with babesiosis are asymptomatic, the actual prevalence of the illness is unknown. Babesiosis is more common in asplenic patients, immune-compromised patients and elderly patients.

Sex distribution
Age distribution

Pathophysiology

Babesiosis is transmitted from animals to humans by tick bite.
The ticks have 3 phases i.e. larva, nymph, and adult. Each of these feed on a blood meal to develop into the next phase. The larva and nymph feed on rodents while an adult feeds on other animals.

The signs and symptoms depend on RBC parasitemia. During the feed, the tick ingests Babesia from the host animal. Then these multiply in the gut wall of the tick and are stored in the salivary glands. These are then inoculated in the new host when the ticks feed on the host.

Once in the blood stream, the parasite infects the RBCs producing trophozoites. These then divide to form merozoites. While leaving the RBC, they damage the RBC membrane. This leads to decreased RBC conformability and increased RBC adherence causing pulmonary edema and acute respiratory distress syndrome in severe cases.

Haemolytic RBCs cause capillary blockage or micro-vascular stasis affecting the liver, spleen, kidneys and the CNS. Haemolytic anaemia is produced due to the rapid RBC destruction. Spleen aids in removal of the damaged RBCs. This explains the high occurrence and increased severity of this disease in asplenic patients [5].

Symptoms of fever, anorexia, arthralgia, myalgia etc. are manifested due to complement activation by Babesia.

Prevention

There are no guidelines for prevention of Babesiosis.

Summary

Babesiosis is a tick-borne malaria-like parasitic illness caused by the protozoa Babesia. It can have a major impact on health, especially of animals.

Babesiosis is transmitted from vertebrate animals to humans [1] [2]. Its symptoms range from fever to haemolytic anaemia. The disease can be fatal.

Patient Information

Babesiosis is caused by a protozoa Babesia. It is a tick-borne malaria-like parasitic illness that infects the red blood cells. The symptoms can vary from no overt illness to highly fatal consequences.

It is a zoonotic disease that is transmitted from animals to humans by ticks. It can also be caused due to transmission of contaminated blood. The severity of the disease is higher in patients who are immuno-compromised or patients with HIV infection.

The incidence of the disease is high in patients who have undergone splenectomy. The signs and symptoms of this disease depend on the extent of RBC destruction due to the parasite. It takes about one to four weeks for the symptoms to appear in patients bitten by the infected tick. In cases where the disease is caused due to blood transfusion it may take one week to six months for the symptoms to appear.

The most common symptom is high grade fever ranging up to 40.9 °C that is 105.6 °F. The parasite enters the RBCs causing severe destruction. This leads to haemolytic anaemia. The damaged RBCs are trapped by the spleen. Hence, splenomegaly is also detected.

Along with fever there is severe malaise, fatigue, severe chills, sweating, anorexia, nausea, vomiting, weight loss, headache, muscle and joint pains, cough, sore throat, photophobia and depression. Blood in urine is also one of the symptoms. The fatigue continues for several months even after the symptoms have healed.

Complications due to Babesiosis are disseminated intravascular coagulopathy and acute respiratory distress syndrome.

Elevated Lactate dehydrogenase (LDH) and a well stained peripheral blood help in the diagnosis of the disease. Polymerase Chain Reaction Assay is a specific test for the diagnosis.

Medical therapy includes antimicrobial agents, oral quinine and intravenous clindamycin.

Patients with a strong immune system experience a complete recovery from the disease as compared to patients who are immuno-compromised.

References

Article

  1. Vannier E, Gewurz BE, Krause PJ. Human babesiosis. Infect Dis Clin North Am. Sep 2008; 22(3):469-88, viii-ix.
  2. Vannier E, Krause PJ. Update on babesiosis. Interdiscip Perspect Infect Dis. 2009; 2009:984568.
  3. Ngo V, Civen R. Babesiosis acquired through blood transfusion, California, USA. Emerg Infect Dis. May 2009;15(5):785-7.
  4. Leiby DA. Transfusion-transmitted Babesia spp.: bull's-eye on Babesia microti. Clin Microbiol Rev. Jan 2011;24(1):14-28.
  5. Martinot M, Zadeh MM, Hansmann Y, Grawey I, Christmann D, Aguillon S, et al. Babesiosis in immunocompetent patients, Europe. Emerg Infect Dis. Jan 2011;17(1):114-6.
  6. White DJ, Talarico J, Chang HG, Birkhead GS, Heimberger T, Morse DL. Human babesiosis in New York State: Review of 139 hospitalized cases and analysis of prognostic factors. Arch Intern Med. Oct 26 1998;158(19):2149-54.
  7. Wormser GP, Lombardo G, Silverblatt F, El Khoury MY, Prasad A, Yelon JA, et al. Babesiosis as a cause of fever in patients undergoing a splenectomy. Am Surg. Mar 2011;77(3):345-7
  8. Kuwayama DP, Briones RJ. Spontaneous splenic rupture caused by Babesia microti infection. Clin Infect Dis. May 1 2008;46(9):e92-5.
  9. Krause PJ, Spielman A, Telford SR 3rd, et al. Persistent parasitemia after acute babesiosis. N Engl J Med. Jul 16 1998;339(3):160-5.
  10. Krause PJ, Lepore T, Sikand VK, Gadbaw J Jr, Burke G, Telford SR 3rd, et al. Atovaquone and azithromycin for the treatment of babesiosis. N Engl J Med. Nov 16 2000;343(20):1454-8.

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Last updated: 2019-07-11 22:34