Babesiosis
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Babesiosis Microchapters |
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Babesiosis On the Web |
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American Roentgen Ray Society Images of Babesiosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Pathophysiology
Epidemiology & Demographics
Risk Factors
Screening
Causes
Differentiating Babesiosis
Complications & Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics
Treatment
Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies
Pathophysiology
Babesia parasites reproduce in red blood cells, where they can be seen as cross-shaped inclusions (4 merozoites asexually budding but attached together forming a structure looking like a "Maltese Cross") and cause hemolytic anemia, quite similar to malaria.
Note that unlike the Plasmodium parasites that cause malaria, Babesia species lack an exo-erythrotic phase, so the liver is usually not affected.
Diagnosis
Babesiosis is easy to diagnose but only if it is suspected. It will not show up on any routine tests. It must be suspected when a persons with exposure in an endemic area develops persistent fevers and hemolytic anemia. Babesiosis can be diagnosed by direct examination of the blood (see photo), with serology, or with PCR-based tests. Other laboratory findings include decreased numbers of red blood cells and platelets on complete blood count.
Treatment
Most cases of babesiosis resolve without any specific treatment. For ill patients, treatment is usually a two-drug regimen. The traditional regimen of quinine and clindamycin is often poorly tolerated; recent evidence suggests that a regimen of atovaquone and azithromycin can be equally effective [1]. In life-threatening cases, exchange transfusion is performed. In this procedure, the infected red blood cells are removed and replaced with fresh ones.
References
- Herwaldt BL, Persing DH, Précigout EA, et al. A fatal case of babesiosis in Missouri: Identification of another piroplasm that infect humans. Ann Intern Med 1996;124:643-65.
- Pershing DH, Herwaldt BL, Glaser C, et al. Infection with a Babesia-like organism in northern California. N Engl J Med 1995;332:298-303.
- ↑ Krause P, Lepore T, Sikand V, Gadbaw J, Burke G, Telford S, Brassard P, Pearl D, Azlanzadeh J, Christianson D, McGrath D, Spielman A (2000). "Atovaquone and azithromycin for the treatment of babesiosis". N Engl J Med. 343 (20): 1454–8. PMID 11078770.
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