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Case Reports
, 11 (4), e4459

Severe Babesiosis Masquerading as Thrombotic Thrombocytopenic Purpura: A Case Report

Case Reports

Severe Babesiosis Masquerading as Thrombotic Thrombocytopenic Purpura: A Case Report

Daniel Chang et al. Cureus.


Babesiosis is an infectious disease caused by protozoa of the genus Babesia. Its incidence has been increasing in the Northeast and upper Midwest regions of the United States in recent years. Symptoms of babesiosis can range from a mild flu-like illness to acute, severe, and fatal disease. Severe disease is common in older populations and immunocompromised patients. The laboratory abnormalities associated with babesiosis, such as low hematocrit, low hemoglobin, elevated lactate dehydrogenase, low haptoglobin, reticulocytosis, the presence of schistocytes on the peripheral blood smear and thrombocytopenia, can mimic other severe systemic disorders like thrombotic thrombocytopenic purpura (TTP). Hence, it is crucial to be aware of babesiosis, especially in highly endemic areas as it can masquerade as severe fatal systemic diseases like TTP.

Keywords: babesiosis; microangiopathic hemolytic anemia.

Conflict of interest statement

The authors have declared that no competing interests exist.


Figure 1
Figure 1. The chest X-ray showing postoperative changes of the right lung, pulmonary fibrosis, and borderline enlarged lower mediastinal lymph nodes adjacent to the distal esophagus.
Figure 2
Figure 2. Wright-Giemsa stained blood smear under the 60x objective showing Babesia parasites in red blood cells (blue triangle arrows), Burr cells (yellow arrows), few polychromasia, slight anisocytosis, and moderate poikilocytosis.
Figure 3
Figure 3. Abdominal ultrasound showing mild splenomegaly.
Figure 4
Figure 4. Abdominal ultrasound showing a 6.2 cm cyst at the upper pole of the left kidney.

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