Babesiosis - Diagnosis and Management Summary Disease: Release of merozoites from erythrocytes and associated loss of cell membrane integrity causing hemolysis Presentation: • Asymptomatic - Mostly in pediatric population • Mild-to-Moderate - Immunocompetent patients, parasitemia < 4%: Chills, sweats, anorexia, headache • Severe: Older and/or immunocompromised patients, parasitemia > 4%: Vomiting, diarrhea, ARDS, shock, CHF, renal failure Diagnosis: • Thin blood smear "Maltese Cross" • PCR (useful in the setting of low-level parasitemia • Serology for confirmation of babesiosis and species identification • IgM antibody is usually detected 2 weeks after onset of illness. Treatment: • Immunocompetent Patient (Mild disease): Oral azithromycin + oral atovaquone (7-10 days) • Immunocompetent Patient (Moderate disease): Oral azithromycin + oral atovaquone (7-10 days) • Immunocompromised Patient with risk of relapse: IV azithromycin + oral atovaquone (7-10 days) up to 2 weeks • Relapse: Repeat course of antibiotic therapy • Alternative Regimen: IV clindamycin + Oral quinine By @TheIDtrivia #Babesiosis #Babesia #Diagnosis #Management #microbiology #InfectiousDiseases
