Babesiosis as a Cause of Fever in Patients Undergoing a Splenectomy

Abstract

Babesiosis is an emerging infection most commonly acquired from a tick bite. We describe three hospitalized patients with fever attributable to babesiosis after a splenectomy. Splenectomy was done because of splenic enlargement due to unsuspected babesia infection in one patient and because of splenic perforation due to babesiosis in a second patient. The third patient underwent splenectomy for trauma and acquired babesiosis postoperatively from a blood transfusion. Our cases demonstrate the need to be vigilant for babesiosis in patients undergoing splenectomy.

Babesiosis in Lower Hudson Valley, New York, USA

“…The only child affected was a 6-week-old infant who acquired B. microti infection perinatally; a detailed case history for this patient will be reported elsewhere. For 2 of the 18 cases in adults, transfusion of infected blood products was believed to have been the route of infection; 1 of these cases is described in more detail elsewhere ( 7 ). Fifteen (94%) of the 16 other adult patients had potential tick exposure in the LHV (tick exposure is defined as exposure to outdoor environments where ticks are likely to reside); for 10 (67%) of these patients, this was the only known tick exposure within 30 days before onset of symptoms.…”

Riboflavin and ultraviolet light reduce the infectivity of Babesia microti in whole blood

“…In fact the final parasite concentration in the spiked units before treatment was 10 6 to 10 7 infected RBCs/mL, which corresponds to a parasitemia of 1% to 10%. This level of parasitemia is frequently associated with symptomatic babesiosis, but can occasionally manifest as severe disease in people with underlying immunosuppressive conditions such as AIDS or splenectomy 17‐20 . While this “overload approach” may be suitable for viruses, when measuring parasite reduction, starting with an unusually high amount of pathogen may carry some disadvantages, especially in a system that requires efficacy to be measured in an in vivo model.…”

Babesia Infection in Humans of Southwest China

“…The patient in the present study was cured by a combined treatment of artemether, azithromycin, and clindamucin through intramuscular injection and oral intake of atovaquone. Babesia is commonly reported to infect human beings with splenectomy ( 1 , 7 ) or anemia ( 8 ). No lesions in the spleen or liver of the patient were observed by the CT scan.…”