Babesia Clinical Presentations: A Case of Variable Symptoms
Babesia clinical presentations can vary widely, ranging from mild symptoms to severe neurologic and systemic illness.
A woman was admitted to the emergency room with fever, chills, lethargy, fatigue, and marked changes in sensorium. Clinicians initially suspected sepsis, but she was later diagnosed with concurrent Babesia and anaplasmosis.
Her case demonstrates how “patients with babesiosis show a wide range of symptoms and clinical presentations,” writes Paparone.
Laboratory Findings in This Babesia Case
The patient’s maximum temperature was 100.6°F. Laboratory abnormalities included:
- Anemia (hemoglobin dropped from 10.5 g/dL to 8 g/dL)
- Leukopenia (5.0 × 10⁹/L to 2.6 × 10⁹/L)
- Thrombocytopenia (down to 39 × 10⁹/L)
- Positive peripheral smear for Babesia
- Babesia IgM titer of 1:160
- Anaplasma IgM titer of 1:320
Clinicians suspected anaplasmosis based on leukopenia and thrombocytopenia.
“Generally, the greater the number of concurrent tick-borne infections and the higher the parasitemia load, the more toxic the presentation.”
Treatment for Babesia and Anaplasmosis
The patient was treated for 14 days with doxycycline, atovaquone, and azithromycin—addressing both Babesia and anaplasmosis.
Her cognitive function improved significantly following treatment, highlighting the potential neurologic impact of Babesia, particularly in older adults.
Why Variable Babesia Presentations Matter
This case highlights the broad spectrum of Babesia symptoms, including effects on mental status.
Recognizing these variable presentations is critical for early diagnosis and appropriate treatment, helping prevent complications and prolonged illness.
Clinical Takeaway
Babesia symptoms can vary widely, and recognizing atypical presentations supports timely diagnosis and treatment.
References
- Paparone P, Paparone PW. Variable clinical presentations of babesiosis. Nurse Pract. 2018;43(10):48-54.
Related Reading
- Babesia and Lyme: What Patients Need to Know
- Delayed Onset of Babesia Highlights Importance of Follow-Up Visits
- Healthy People May Be Unaware They Are Infected with Babesia
- Blood Donor Infects Premature Infants with Babesia
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
