Id: 53: sever symptomatic babesiosis co-infection with lyme disease

Discussion Humans are opportunistic hosts to Babesia when bitten by nymph or adult ticks; the most known ticks are Ixodes. Babesiosis should be considered in patients who have a malaria-like illness in areas endemic for Babesia infection. The symptoms usually begin 2–4 weeks after a tick bite. The presentation includes constitutional symptoms, abdominal pain and dark urine. Labs finding include hemolytic anemia and elevated liver enzymes. Urinalysis reveals hemoglobinuria without red blood cells. The diagnosis of Babesiosis is usually established by microscopic examination of Giems or Wright-stained blood smears, indirect immunofluorescent antibody tests and PCR. In healthy individuals with intact spleens, the symptoms resolve spontaneously without treatment. For mild to moderate babesiosis, combination therapy with atovaquone and azithromycin for 7 days. However, in patients who are asplenic or immunocompromized, babesiosis is quite severe and is associated with higher mortality, the preferred treatment is intravenous clindamycin and oral quinine. In patients who are refractory to pharmacological treatment, red blood cells exchange transfusion has been shown to improve mortality. It is very important to consider other tick-borne agents that may be co-transmitted with Babesia such as B. burgdorferi; the agent of Lyme disease. Co-infection should be considered in patients with a poor response to conventional antimicrobial therapy or atypical clinical presentations. When ...
Source: Journal of Investigative Medicine - Category: Research Authors: Tags: Infectious Disease Source Type: research