Babesia Infection in a 6-Week-Old Infant
Babesia can affect even very young infants.
A 6-week-old baby developed a tick-borne infection in Long Island.
The diagnosis was delayed because symptoms were nonspecific.
This case was described in the journal Pediatrics by Handel and colleagues in 2019.
Babesia infection in infants is rare, but this case highlights how even very young babies can develop tick-borne disease in endemic areas such as Long Island, New York.
How the Infant Was Likely Exposed to Babesia
The infant reportedly spent very little time outdoors. However, there was tall grass in the yard, and the father worked painting home exteriors, which may have increased the likelihood of tick exposure.
The parents did not recall seeing a tick. Instead, they removed what they believed to be a bloody “flea” from the infant’s arm approximately 20 days before hospitalization.
This case illustrates how difficult it can be to recognize very small ticks.
Babesia is transmitted by the same ticks that can carry Lyme disease and other tick-borne co-infections.
Babesia can also be transmitted through the blood supply or during pregnancy.
Symptoms of Babesia Infection in Infants
The infant developed fever, irritability, vomiting, and poor feeding.
Initial laboratory testing revealed anemia and a low platelet count, but doctors were initially unable to determine the cause of the illness.
Physicians began treatment with broad-spectrum antibiotics while continuing the evaluation.
The baby was transferred to a second hospital where repeat laboratory testing again showed anemia, thrombocytopenia, abnormal liver function tests, and an enlarged spleen.
Infants can develop Babesia even when tick exposure is not recognized.
Symptoms of Babesia in infants are often nonspecific.
Diagnosis of Babesia in the Infant
A blood test eventually revealed Babesia parasites inside red blood cells under the microscope.
Approximately 3.6% of the infant’s red blood cells were infected.
Babesia infects red blood cells and may lead to severe anemia, low platelets, enlargement of the spleen, and abnormal liver function studies.
Treatment of Babesia in a 6-Week-Old Infant
The infant was treated with oral atovaquone and intravenous azithromycin.
His anemia worsened during treatment, and his hemoglobin dropped to 6.9 g/dL, requiring a blood transfusion.
Because Babesia and Lyme disease can occur together, doctors also prescribed amoxicillin for possible Lyme disease co-infection.
You can read more about Babesia treatment options.
Fortunately, the infant remained well on follow-up.
What This Babesia Infant Case Teaches Us
- Babies can develop tick-borne infections even with limited outdoor exposure.
- Parents may not recognize ticks because they can be extremely small.
- Symptoms of Babesia in infants are often nonspecific.
- Diagnosis may require careful laboratory evaluation and follow-up.
FAQ: Babesia Infection in Infants
Can infants get Babesia from a tick bite?
Yes. This case demonstrates that even a 6-week-old infant can develop Babesia after likely tick exposure.
What symptoms can Babesia cause in infants?
Symptoms may include fever, irritability, vomiting, poor feeding, anemia, and low platelet counts.
How is Babesia diagnosed?
Diagnosis may be made when parasites are identified inside red blood cells on a blood smear.
Related Reading
References:
- Handel AS, Hellman H, Hymes SR. Two Neonates With Postnatally Acquired Tickborne Infections. Pediatrics. 2019.
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
