Babesia in Infants: 6-Week-Old Boy Case

Welcome to another Inside Lyme Podcast. One of the best ways to understand tick-borne illness is through reviewing real clinical cases. In this episode, I discuss a 6-week-old boy diagnosed with Babesia, a serious tick-borne infection that can be difficult to recognize in infants.

Babesia infection in infants can lead to severe anemia and low platelet counts, making early recognition critical in areas where tick-borne diseases are common.

This case was first described in the journal Pediatrics by Handel and colleagues in 2019.

Babesia Infection in Infants

The doctors were initially unable to determine why the infant was ill or why he had anemia and a low platelet count. While searching for the cause of the illness, they prescribed three antibiotics — ampicillin, ceftriaxone, and vancomycin.

Laboratory testing later revealed the parasite Babesia inside the infant’s red blood cells under the microscope.

The baby was treated with oral atovaquone and intravenous azithromycin.

His anemia worsened. His hemoglobin dropped to 6.9 g/dL, which is quite low. Because of the severity of the anemia, the doctors transfused one unit of blood.

The physicians were also concerned that the infant might have Lyme disease. Because of this possibility, they added 14 days of amoxicillin to the treatment.

The baby remained well on follow-up, according to the authors.

Clinical Takeaway

This case highlights how difficult it can be to diagnose Babesia in a very young infant. Severe anemia and thrombocytopenia may be the first signs of infection.

Babesia is one of several Lyme disease coinfections transmitted by deer ticks. Clinicians evaluating infants with unexplained anemia or severe illness in endemic areas should consider tick-borne infections in their differential diagnosis.

Inside Lyme Podcast Series

You can hear more about these cases through my blogs, social media, and YouTube. Sign up for our newsletter to keep up with our case discussions.

You can read the full text of this podcast at:

https://danielcameronmd.com/lyme-disease-podcast-6-week-old-boy-babesia/

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Dr. Cameron is a Lyme disease expert and the author Inside Lyme: An Expert’s Guide to the Science of Lyme Disease. He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice for any particular patient. If you require specific advice, please seek care from an experienced healthcare professional.