Two Imported Cases of Babesiosis with Complication or Co-Infection with Lyme Disease in Republic of Korea

Abstract

Babesiosis, caused by Babesia microti and B. divergens, is transmitted by Ixodid ticks. Symptoms of babesiosis vary from a mild flu-like illness to acute, severe, and sometimes fatal and fulminant disease. In Korea, 7 imported babesiosis cases and 1 endemic case have been reported. We report 2 cases of severe babesiosis initially mistaken as malaria. The first patient was complicated by shock and splenic infarction, the other co-infected with Lyme disease. As the population traveling abroad increases every year, physicians should be aware of babesiosis which mimics malaria, co-infection with other diseases, and its complications.

Splenic Complications ofBabesia microtiInfection in Humans: A Systematic Review

“…All reported cases in this review were from the US except for one patient who might have contracted the infection in Ecuador [33]. Another case was reported in South Korea; however, in that case, the disease had been acquired in New Jersey, USA [39]. In multivariate analysis, neither age nor sex was associated with splenectomy as an outcome (Table 2).…”

“…Of 34 cases reported, 19 cases were collected from single case reports; there were 4 case series, each including 2 cases [22,23,27,37]. Finally, there was one case series including 7 patients from a single institution in Rhode Island, USA [39].…”

iSeq100 for metagenomic pathogen screening in ticks

“…Ixodid ticks (including Haemaphysalis longicornis) have been recognized as vectors of pathogens causing diseases such as babesiosis, borreliosis, rickettsiosis, and severe fever with thrombocytopenia syndrome (SFTS) in Korea [8][9][10][11][12][13][14]. Rickettsia spp.…”

A Practical Approach to the Diagnosis of Lyme Borreliosis: From Clinical Heterogeneity to Laboratory Methods

“…The main tick vector for Borrelia species in Europe is the Ixodes ricinus ( 2 ), in America the Ixodes scapularis and Ixodes pacificus ( 3 – 5 ), while in Asia ( 6 ) and Russia ( 7 ) it is the Ixodes persulcatus . These ticks are possible vectors of Lyme Borreliosis (LB) as well as other pathogens, including viruses, intracellular bacteria, and Protozoa which can co-infect humans (LB co-infections) ( 8 , 9 ). There are several B. burgdorferi sensu lato genospecies, directly associated with human LB.…”

“…However, only three genospecies, namely Borrelia burgdorferi sensu stricto, B. afzelii , and B. garinii , have been systemically related to LB ( 4 , 10 ). In addition, four other genospecies have been occasionally detected in humans: B. bissettiae ( 4 , 5 ), B. lusitaniae ( 6 , 7 ), B. spielmanii ( 8 ), and B. valaisiana ( 9 ), especially in Europe ( 11 ). Specificity in terms of dominating hosts has been reported both across and within continents ( 12 , 13 ).…”