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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{CMG}}
{{Babesiosis}}
{{About1|Babesia microti}}
{{SK}} Babesia microti, Texas cattle fever, Redwater, or Piroplasmosis


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{{CMG}} {{AE}} {{IMD}}


'''Babesiosis''' is an uncommon [[malaria]]-like [[parasitic disease]] caused by [[protozoa]]n parasites of the genus ''[[Babesia]]''.
==[[Babesiosis overview|Overview]]==


== Epidemiology ==


Babesiosis is a [[Vector (biology)|vector]]-borne illness usually transmitted by [[tick]]s.  (''Babesia microti'' uses the same tick vector, ''[[Ixodes scapularis]]'', as [[Lyme disease]] does, and frequently occurs in conjunction with it.)  In ''babesia''-endemic areas, the organism can also be transmitted by [[blood transfusion]].  The disease exists mostly in Eastern Long-Island and its barrier island, Fire Island, and the islands off the coast of Massachusetts. It is sometimes called "The Malaria of The North East."
==[[Babesiosis historical perspective|Historical Perspective]]==


Babesiosis causes a disease very similar to Malaria.  In mild cases, people may experience mild fevers and anemia.  In more severe cases, fevers go up to 105 degrees with shaking chills, and anemia (hemolytic anemia) can become severe.  Organ failure may follow including adult respiratory distress syndrome. 


Infection with ''Babesia'' parasites can be asymptomatic or cause a mild non-specific illness, and therefore many cases go unnoticed.  It may also cause severe disease.  While most severe cases occur in the very young, very old, or persons with underlying medical conditions (such as [[immunodeficiency]]) and those without a spleen, they can occur in normal individuals.  Indeed, both the incidence or all cases of babesiosis and severe cases are increasing rapidly.  Some cases are identified when patients with another tick-borne illness are screened for babesiosis.
==[[Babesiosis pathophysiology|Pathophysiology]]==


Little is known about the occurrence of ''Babesia'' species in malaria-[[Endemic (epidemiology)|endemic]] areas, where ''Babesia'' can easily be misdiagnosed as ''[[Plasmodium]]''.


== Pathophysiology ==
==[[Babesiosis causes|Causes]]==


''Babesia'' parasites reproduce in [[red blood cell]]s, where they can be seen as cross-shaped inclusions (4 [[merozoite]]s asexually budding but attached together forming a structure looking like a "Maltese Cross") and cause [[hemolytic anemia]], quite similar to [[malaria]].


Note that unlike the ''[[Plasmodium]]'' parasites that cause malaria, ''Babesia'' species lack an exo-erythrotic phase, so the liver is usually not affected.
==[[Babesiosis differential diagnosis|Differentiating Babesiosis from other Diseases]]==


== Diagnosis ==
==[[Babesiosis epidemiology and demographics|Epidemiology and Demographics]]==


Babesiosis is easy to diagnose but only if it is suspected.  It will not show up on any routine tests.  It must be suspected when a persons with exposure in an endemic area develops persistent fevers and hemolytic anemia.  Babesiosis can be diagnosed by direct examination of the blood (see photo), with [[serology]], or with [[PCR]]-based tests.  Other laboratory findings include decreased numbers of [[red blood cells]] and [[platelets]] on [[complete blood count]].


== Treatment ==
==[[Babesiosis risk factors|Risk Factors]]==


Most cases of babesiosis resolve without any specific treatment.  For ill patients, treatment is usually a two-drug regimen.  The traditional regimen of [[quinine]] and [[clindamycin]] is often poorly tolerated; recent evidence suggests that a regimen of [[atovaquone]] and [[azithromycin]] can be equally effective <ref name=Krause>{{cite journal | author = Krause P, Lepore T, Sikand V, Gadbaw J, Burke G, Telford S, Brassard P, Pearl D, Azlanzadeh J, Christianson D, McGrath D, Spielman A | title = Atovaquone and azithromycin for the treatment of babesiosis | journal = N Engl J Med | volume = 343 | issue = 20 | pages = 1454-8 | year = 2000 | id = PMID 11078770}}</ref>.  In life-threatening cases, exchange transfusion is performed.  In this procedure, the infected red blood cells are removed and replaced with fresh ones. 


== References ==
==[[Babesiosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
* Herwaldt BL, Persing DH, Précigout EA, et al. A fatal case of babesiosis in Missouri: Identification of another piroplasm that infect humans. Ann Intern Med 1996;124:643-65.
* Pershing DH, Herwaldt BL, Glaser C, et al. Infection with a Babesia-like organism in northern California. N Engl J Med 1995;332:298-303.


<references/>


==See also==
*[[Andrew Spielman]]


== External links ==
==Diagnosis==
* http://www.dpd.cdc.gov/dpdx/HTML/Babesiosis.htm - [[Public domain]] source from which the first version of this article was derived.
[[Babesiosis history and symptoms|History and Symptoms]] | [[Babesiosis physical examination|Physical Examination]] | [[Babesiosis laboratory findings|Laboratory Findings]]
 
==Treatment==
[[Babesiosis medical therapy|Medical Therapy]] | [[Babesiosis primary prevention|Prevention]]
 
 
==Case Studies==
[[Babesiosis case study one|Case #1]]
 
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Latest revision as of 17:04, 18 September 2017

For patient information click here

Babesiosis Microchapters

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Overview

Historical Perspective

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Pathophysiology

Causes

Differentiating Babesiosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Treatment

Medical Therapy

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Case #1

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This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Babesia microti.

Synonyms and keywords: Babesia microti, Texas cattle fever, Redwater, or Piroplasmosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ilan Dock, B.S.

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Babesiosis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings

Treatment

Medical Therapy | Prevention


Case Studies

Case #1

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