Babesiosis

What is babesiosis?

Babesiosis is a parasite. infection caused by protozoa of the genus Babesia. Several species of Babesia cause the disease throughout the world. Most of the reported cases have occurred in the United States, with Babesia microti being the main species responsible.

Babesias are transmitted by the bite of ixodid ticks. These ticks are the same vector responsible for the transmission of Lyme disease and, consequently, around 20% of patients with babesiosis are co-infected with Lyme disease. In addition to the tick vector, Babesia requires a vertebrate reservoir, most commonly mice or cattle. Ticks are most often found in wooded or grassy areas. Tick transmission generally occurs between the months of May to October.

the predominance of babesiosis is unknown, because most patients are symptom-free. Surveys using serological Tests for evidence of past infection have shown that around 10% of the population has been infected endemic areas, like Rhode Island. Other areas of the United States where tick transmission occurs include the Northeast and Upper Midwest, especially parts of New England, New York State, New Jersey, Wisconsin, and Minnesota.

While most cases of babesiosis are transmitted by ticks, cases of diseases associated with blood transfusions have been reported.

What are the clinical features of babesiosis?

After a bite from an infected tick, Babesia causes lysis (rupture) of the hostRed blood cells. Clinical features vary from mild or no symptoms to severe illness and death.

• In healthy individuals, babesiosis usually has no symptoms.
• Some people experience a flu-like illness, with 1-2 weeks of fatigue, discomfort, fever, chills and sweating. the incubation The period after a tick bite is around 1-4 weeks.
• The disease is more severe in elderly patients with impaired immunity or without a spleen. These patients may experience jaundice, congestive heart failure, renal failure, acute respiratory distress syndrome, disseminated intravascular coagulationOr death. Among patients with symptomatic infections, the mortality rate is 10% in the United States and 50% in Europe (mainly in patients without a spleen).

Cutaneous manifestations of babesiosis.

• The cutaneous manifestations of babesiosis are rare and difficult to separate from those of Lyme disease. Co-infection with Babesia can alter the skin manifestations of Lyme disease.
• No consistent cutaneous manifestations of babesiosis have been found.
• Eruption it has been identified as the presenting symptom in about 12% of hospitalized babesiosis patients.
• Petechiae (small red or purple spots due to bleeding on the skin) and bruising may occur, most likely due to thrombocytopenia (low platelets, which causes abnormal blood clotting).
• Jaundice has been reported, most likely due to lysis of red blood cells.

How is babesiosis diagnosed?

Consider a diagnosis of babesiosis in:

• Patients with suspected Lyme disease that is resistant to treatment.
• Elderly, impaired immunity, or asplenic patients, with an undiagnosed diagnosis. febrile disease, which have been in endemic areas.

The definitive diagnosis of babesiosis can be made by:

• Microscopic blood smear examination, using Wright or Giemsa stain. This will display the organisms within the host's red blood cells. A false negative result can occur in patients without symptoms.
• Polymerase chain reaction can detect Babesia genetic material and is useful when there are few circulating parasites (eg, when symptoms begin and during convalescence).
• Antibody test immunofluorescence.

What is the treatment for babesiosis?

• If the patient is healthy and without symptoms, no treatment is necessary.
• Elderly patients with impaired immunity or asplenic patients are treated with a combination of clindamycin and quinine; or atovaquone and azithromycin.
• In severe cases, an exchange transfusion of whole blood (collection of infected blood and replacement by fresh donor blood) may be necessary to reduce the level of parasites circulating in the blood.

How can babesiosis be prevented?

• Those at risk of severe infection with babesiosis should avoid endemic areas between May and October.
• Long-sleeved clothing and pants should be worn when outdoors to cover as much skin as possible.
• DEET insect repellent should be applied to skin and clothing.
• Ticks must remain attached for at least 24 hours to transmit Babesia. Therefore, early removal of ticks from humans and pets should prevent disease transmission. Careful daily checks for ticks are important as the tick can be as small as a poppy seed.