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2017 ; 16
(1
): 6
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Hematologic manifestations of babesiosis
#MMPMID28202022
Akel T
; Mobarakai N
Ann Clin Microbiol Antimicrob
2017[Feb]; 16
(1
): 6
PMID28202022
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BACKGROUND: Babesiosis, a zoonotic parasitic infection transmitted by the Ixodes
tick, has become an emerging health problem in humans that is attracting
attention worldwide. Most cases of human babesiosis are reported in the United
States and Europe. The disease is caused by the protozoa of the genus Babesia,
which invade human erythrocytes and lyse them causing a febrile hemolytic anemia.
The infection is usually asymptomatic or self-limited in the immunocompetent
host, or follows a persistent, relapsing, and/or life threatening course with
multi-organ failure, mainly in the splenectomized or immunosuppressed patients.
Hematologic manifestations of the disease are common. They can range from mild
anemia, to severe pancytopenia, splenic rupture, disseminated intravascular
coagulopathy (DIC), or even hemophagocytic lymphohistiocytosis (HLH). CASE
PRESENTATION: A 70 year old immunocompetent female patient living in New York
City presented with a persistent fever, night sweats, and fatigue of 5 days
duration. Full evaluation showed a febrile hemolytic anemia along with
neutropenia and thrombocytopenia. Blood smear revealed intraerythrocytic Babesia,
which was confirmed by PCR. Bone marrow biopsy was remarkable for
dyserythropoiesis, suggesting possible HLH, supported by other blood workup
meeting HLH-2004 trial criteria. CONCLUSION: Human babesiosis is an increasing
healthcare problem in the United States that is being diagnosed more often
nowadays. We presented a case of HLH triggered by Babesia microti that was
treated successfully. Also, we presented the hematologic manifestations of this
disease along with their pathophysiologies.
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