Babesiosis is caused by a protozoa that infects red blood cells (erythrocytes).
The clinical features of babesiosis are similar to those of malaria and range in severity from asymptomatic to rapidly fatal. Most patients experience a viral infection–like illness with fever, chills, sweats, myalgia, arthralgia, anorexia, nausea, vomiting, or fatigue. On physical examination, fever, splenomegaly, hepatomegaly, or jaundice may be observed. Laboratory findings may include hemolytic anemia with an elevated reticulocyte count, thrombocytopenia, proteinuria, and elevated levels of liver enzymes, blood urea nitrogen, and creatinine. Complications of babesiosis include acute respiratory failure, disseminated intravascular coagulation, congestive heart failure, coma, and renal failure. Immunocompromised patients, such as those who lack a spleen, have a malignancy or HIV infection, or who exceed 50 years of age, are at increased risk of severe babesiosis. Approximately one-quarter of infected adults and one-half of children experience asymptomatic infection or such mild viral–like illness that the infection is only incidentally diagnosed by laboratory testing. In both untreated and treated patients, parasitemia may occasionally persist, resulting either in subsequent recrudescence weeks or months later (primarily in immunocompromised hosts) or, rarely, in transmission of the pathogen to others through blood transfusion.
The clinical features of babesiosis are similar to those of malaria and range in severity from asymptomatic to rapidly fatal. Most patients experience a viral infection–like illness with fever, chills, sweats, myalgia, arthralgia, anorexia, nausea, vomiting, or fatigue. On physical examination, fever, splenomegaly, hepatomegaly, or jaundice may be observed. Laboratory findings may include hemolytic anemia with an elevated reticulocyte count, thrombocytopenia, proteinuria, and elevated levels of liver enzymes, blood urea nitrogen, and creatinine. Complications of babesiosis include acute respiratory failure, disseminated intravascular coagulation, congestive heart failure, coma, and renal failure. Immunocompromised patients, such as those who lack a spleen, have a malignancy or HIV infection, or who exceed 50 years of age, are at increased risk of severe babesiosis. Approximately one-quarter of infected adults and one-half of children experience asymptomatic infection or such mild viral–like illness that the infection is only incidentally diagnosed by laboratory testing. In both untreated and treated patients, parasitemia may occasionally persist, resulting either in subsequent recrudescence weeks or months later (primarily in immunocompromised hosts) or, rarely, in transmission of the pathogen to others through blood transfusion.
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