Babesiosis can be transmitted by a tick bite, blood transfusion, or perinatally, from mother to child

Babesiosis can be transmitted by a tick bite, blood transfusion, or perinatally, from mother to child. Classical treatment may consist of drug regimens like Mepron and Zithromax, or Clindamycin and Quinine. Treatment does not usually require a blood transfusion among those who are immunocompetent with an intact spleen, despite the fact that classical regimens may not fully eradicate the parasite. In this clinical study published in Case Reports in Infectious Diseases, the patient was found to have B. microti on a blood smear, and was reported to have been successfully treated with an exchange transfusion and IV Cleocin and Quinine after failing Mepron and Zithromax. No long term follow-up however was reported, and the majority of my patients with chronic Lyme disease and Babesiosis have evidence of persistent infection and relapsing disease (Krause, P.J. et al. Persistent Parasitemia After Acute Babesiosis. NEJM 1998; Horowitz, R. Chronic Persistent Babesiosis after Clindamycin and Quinine/ Mepron +Zithromax. Abstract 12th Int Conference on Lyme Borreliosis, April 1999 NYC). There is known Mepron resistance in the United States although it has only been reported in the literature in immuncompromised patients (Krause, PJ et al. Emergence of Resistance to Azithromycin-Atovaquone in Immunocomprised patients with Babesia microti infections. Clin Inf Dis. 2010 Jan 4) and severe hemolytic anemia as a presenting complaint in immunocompetent patients with intact spleens has been reported (Iacopino, et al. Life threatening babesiosis in a woman from Wisconsin; Arch Intern Med 1990 Jul;150(7):1527-8). No evidence of other immune testing (for example, immunoglobulin levels and subclasses) or associated tick-borne infections (i.e., Lyme, Bartonella, Ehrlichia, Anaplasma, rickettsial infections) was discussed in this case report (despite low platelet counts and elevated liver functions, which can be seen with these co-infections), and multiple co-infections have been known to cause increased severity of illness. http://www.hindawi.com/journals/criid/2015/405263/
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