Babesiosis Information for Health Professionals

Babesia microti is a protozoan of the piroplasm family.

On this page:
Clinical Presentation
Supportive Laboratory Findings
Diagnosis
Treatment
Guidelines
Reporting

Babesiosis

Babesiosis is a malaria-like illness caused by red blood cell parasites (Babesia spp.). It is carried by the same ticks that carry Lyme disease.

  • MDH recommends at least 2 of the following 3 tests: PCR, peripheral blood smear, or serology.
  • Recommended treatment is atovaquone + azithromycin (mild to moderate cases) or clindamycin + quinine (severe cases) x 7-10 days. Repeated treatment and monitoring of parasitemia levels may be necessary for patients with certain forms of immune compromise.
  • Transfusion-transmitted babesiosis can occur and should be considered in transfusion recipients who develop anemia, thrombocytopenia, or a febrile illness after receiving cellular blood products. Suspect cases should be promptly reported to associated blood banks and MDH.
Full May 6, 2011: Tick-borne Disease Health Alert

 

Clinical Presentation

  • The clinical spectrum ranges from mild and self-limited to serious.
  • Severe infections are most common in patients who have had a splenectomy or are otherwise immunosuppressed.
  • A gradual onset of illness may include: malaise, anorexia, and fatigue followed more acutely by fever, chills, myalgias, arthralgias, nausea and vomiting.
  • Hypotension and renal failure have been reported.
  • Cases of babesiosis acquired through blood transfusions have been documented. Include babesiosis in the rule-out for patients who develop a febrile illness with thrombocytopenia following blood transfusion. Suspected transfusion-associated babesiosis should be reported to MDH and the supplying blood center.

Supportive Laboratory Findings

  • Supportive laboratory findings include:
    • thrombocytopenia
    • hemolysis
    • hepatic dysfunction

Diagnosis

  • In acutely ill patients, careful examination of blood smears by experienced individuals usually reveals intraerythrocytic parasites.
  • Other tests include polymerase chain reaction (PCR) and indirect immunofluorescence assay (IFA).
  • Coinfections with Borrelia burgdorferi (Lyme disease agent) or Anaplasma phagocytophilum (the agent of human anaplasmosis) can also occur, increasing illness severity.

Treatment

  • Babesiosis is treated with quinine plus clindamycin, or with atovaquone plus azithromycin; treatment should be undertaken with the assistance of an infectious disease specialist.

Guidelines

  • IDSA Babesiosis Disease Guidelines
    The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America. Attention: Non-MDH link

Reporting

  • Reporting Babesiosis
    Minnesota Rules Governing Communicable Diseases require health care providers to report confirmed or suspected cases of Babesiosis to the Minnesota Department of Health (MDH) within 1 working day.

MDH staff also are available to provide clinical consultation regarding diagnosis and treatment of Babesiosis and other tick-borne diseases. Call 651-201-5414 for a clinical consultation.

More information

 

Updated Friday, 06-May-2011 09:18:15 CDT