From the Guidelines
Babesiosis symptoms range from mild to severe and can include fever, chills, sweating, fatigue, headache, muscle aches, joint pain, and loss of appetite. The disease can be asymptomatic in some individuals, making it difficult to diagnose. Symptoms typically appear 1-4 weeks after a tick bite, though many patients don't recall being bitten. Severe cases are more common in elderly individuals, those without a spleen, with weakened immune systems, or with other serious health conditions. These patients may develop complications like low blood pressure, respiratory failure, kidney failure, or even death. Babesiosis is caused by Babesia parasites (primarily B. microti in the US) that infect red blood cells after transmission through the bite of infected blacklegged ticks. Some key symptoms and signs include:
- Fever
- Chills
- Sweats
- Myalgia
- Arthralgia
- Anorexia
- Nausea
- Vomiting
- Fatigue
- Splenomegaly
- Hepatomegaly
- Jaundice
- Hemolytic anemia with an elevated reticulocyte count
- Thrombocytopenia
- Proteinuria
- Elevated levels of liver enzymes, blood urea nitrogen, and creatinine 1. If you experience these symptoms after potential tick exposure, seek medical attention promptly as treatment with antiparasitic medications like atovaquone plus azithromycin or clindamycin plus quinine is most effective when started early. In severe cases, partial or complete RBC exchange transfusion may be indicated, especially in patients with high-grade parasitemia, significant hemolysis, or renal, hepatic, or pulmonary compromise 1. Patients with moderate-to-severe babesiosis should be monitored closely during therapy to ensure clinical improvement and improvement of parasitemia and other laboratory abnormalities 1.
From the Research
Symptoms of Babesiosis
The symptoms of babesiosis can range from mild to severe and may include:
- Flu-like illness
- Anemia
- Thrombocytopenia
- Hemolytic anemia
- Disseminated intravascular coagulation
- Acute renal failure
- Respiratory failure
- Fever
- Hemolysis
Severity of Symptoms
The severity of symptoms can vary depending on the individual and may be more severe in certain groups, such as:
- Immunocompromised individuals
- Those who have undergone splenectomy
- Older adults
- Individuals with underlying medical conditions
Diagnosis and Treatment
Diagnosis of babesiosis is typically confirmed by identification of Babesia parasites on blood smear or Babesia DNA with polymerase chain reaction 2, 3, 4. Treatment usually consists of a 7-10 day course of antibiotics, such as clindamycin and quinine, or atovaquone and azithromycin 3, 4, 5. In severe cases, exchange transfusion may be necessary to reduce parasite load and replace damaged red blood cells 2, 3, 6.