Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 3 (1), 45-51

Babesiosis Diagnosis and Treatment

Affiliations
Review

Babesiosis Diagnosis and Treatment

Peter J Krause. Vector Borne Zoonotic Dis.

Abstract

Human babesiosis due to Babesia microti is an emerging malaria-like infection that is endemic in parts of the northeastern and northcentral United States. The clinical manifestations of babesiosis range from subclinical illness to fulminant disease resulting in death. Prompt and accurate diagnosis is difficult because the signs and symptoms are non-specific. A CBC is a useful screening test since anemia and thrombocytopenia are commonly observed and parasites may be visualized on blood smear. Conclusive diagnosis of this disease generally depends upon microscopic examination of thin blood smears. Babesia frequently are overlooked, however, because parasitemia tends to be sparse, often infecting fewer than 1% of erythrocytes early in the course of the illness. Identification of amplifiable babesial DNA by polymerase chain reaction (PCR) has comparable sensitivity and specificity to microscopic analysis of thin blood smear for detection of babesia in blood. Serologic testing provides useful supplementary evidence of infection because a robust antibody response characterizes human babesial infection, even at the time that parasitemia first becomes detectable. The currently recommended therapy for babesiosis is a 7-10-day course of clindamycin (600 mg every 6 h) and quinine (650 mg every 8 h). Recently, azithromycin (500-600 mg on day 1, and 250-600 mg on subsequent days) and atovaquone (750 mg every 12 h) was found to be equally effective in treating adults experiencing babesiosis. This combination also was associated with fewer adverse reactions than clindamycin and quinine. Exchange transfusion is a potentially life-saving therapy for patients suffering from severe disease with high parasitemia (>5%), significant hemolysis, or renal or pulmonary compromise. Babesiosis may be prevented by avoiding areas such as tall grass and brush where ticks, deer, and mice are known to thrive.

Similar articles

  • Human babesiosis.
    Vannier E, Gewurz BE, Krause PJ. Vannier E, et al. Infect Dis Clin North Am. 2008 Sep;22(3):469-88, viii-ix. doi: 10.1016/j.idc.2008.03.010. Infect Dis Clin North Am. 2008. PMID: 18755385 Free PMC article. Review.
  • Atovaquone and azithromycin for the treatment of babesiosis.
    Krause PJ, Lepore T, Sikand VK, Gadbaw J Jr, Burke G, Telford SR 3rd, Brassard P, Pearl D, Azlanzadeh J, Christianson D, McGrath D, Spielman A. Krause PJ, et al. N Engl J Med. 2000 Nov 16;343(20):1454-8. doi: 10.1056/NEJM200011163432004. N Engl J Med. 2000. PMID: 11078770 Clinical Trial.
  • Persistent parasitemia after acute babesiosis.
    Krause PJ, Spielman A, Telford SR 3rd, Sikand VK, McKay K, Christianson D, Pollack RJ, Brassard P, Magera J, Ryan R, Persing DH. Krause PJ, et al. N Engl J Med. 1998 Jul 16;339(3):160-5. doi: 10.1056/NEJM199807163390304. N Engl J Med. 1998. PMID: 9664092
  • Atovaquone and azithromycin treatment for babesiosis in an infant.
    Raju M, Salazar JC, Leopold H, Krause PJ. Raju M, et al. Pediatr Infect Dis J. 2007 Feb;26(2):181-3. doi: 10.1097/01.inf.0000250622.11505.8f. Pediatr Infect Dis J. 2007. PMID: 17259886
  • Human babesiosis.
    Krause PJ. Krause PJ. Int J Parasitol. 2019 Feb;49(2):165-174. doi: 10.1016/j.ijpara.2018.11.007. Epub 2019 Jan 26. Int J Parasitol. 2019. PMID: 30690090 Review.
See all similar articles

Cited by 18 articles

See all "Cited by" articles

Publication types

Substances

LinkOut - more resources

Feedback