Babesiosis

Question 1

What is babesiosis?

Answer 1

Parasitic infection

B. microti: NE & upper midwestern US
B. divergens: Europe, Missouri
B. duncanii: CA/WA

Deer/small rodent parasite, transmitted by tick or transfusion of infected blood

May-Sept = highest risk of transmission

Question 1

Whats the clinical presentation of babesiosis?

Answer 1

In young/healthy: mild flu like illness

In asplenic, immunocompromised, elderly: life-threatening malaria like infection – fever (intermittent/sustained), shaking chills, fatigue, malaise, arthralgias, myalgias, shortness of breath, hepatosplenomegaly

Question 2

How do you diagnose Babesiosis?

Answer 2

Travel to endemic areas/transfusion

Clinical presentation

Lab findings: anemia, thrombocytopenia, normal or decreased WBC, mild liver dysfunction, proteinurea, hemogloinuria

Blood smear: ring forms similar to malaria, maltese cross

immunofluorescence assay, PCR

Question 3

What else should you check for if a patient has babeiosis?

Answer 3

Lyme

Human granulocytotropic anaplasmosis

They all have the same vector

Question 4

What are potential complications of B. microti?

Answer 4

resp, heart, and kidney failure

severe anemia

worse with high parasitemia

fatal in 5-10% who are hospitalized

Question 5

How do you treat Babeiosis?

Answer 5

Mild: B. microtii: atovaquone+ azithromycin

Severe B. microtii: clindamycin + quinine

B. divergens: immediate complete RBC exchange transfusion+ clindamycin & quinine