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



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