Two Children Who Contracted Babesia From Their Mothers

From the Archives (2020)

This article reflects clinical discussion of pediatric Babesia cases at a time when maternal–fetal transmission was rarely considered outside of published case reports.

Two pediatric cases raised concern for possible maternal–fetal transmission of Babesia. These cases were originally described by Saetre and colleagues in 2017 in the Journal of the Pediatric Infectious Diseases Society.

In both cases, the mothers had been treated for Lyme disease during pregnancy. The infants were born appearing healthy and were discharged home. In one case, the infant had a positive PCR test for Babesia prior to discharge, but treatment was not initiated. Both children later returned to the hospital with symptomatic babesiosis, requiring prolonged hospitalization and treatment.

At the time these cases were reported, congenital or perinatal transmission of Babesia was not routinely considered in pediatric evaluations.

Clinical Implications

These cases highlight the diagnostic challenges associated with Babesia infection in infants and young children. When symptoms emerge after birth, infection acquired during pregnancy or delivery may not be immediately recognized.

Babesiosis in children can present with:

1. Fever

2. Anemia

3. Fatigue

4. Irritability

5. Poor feeding

6. Laboratory evidence of hemolysis

Delayed recognition may contribute to more severe disease and prolonged hospitalization.

Why These Cases Matter

Babesia is most commonly discussed in the context of tick exposure, yet these cases raise concern that vertical transmission may occur, even when infants appear well at birth.

Importantly, these reports do not establish frequency or prevalence. Rather, they underscore the need for:

1. Clinical awareness

2. Careful maternal history

3. Consideration of Babesia in infants with unexplained febrile or hematologic illness

Related Clinical Discussion

These cases were discussed in greater detail in a 2020 episode of the Inside Lyme Podcast, where pediatric Babesia and diagnostic considerations were reviewed.

References

Journal of the Pediatric Infectious Diseases Society Saetre K, et al. Congenital babesiosis: Case reports and review of the literature.
2017.