Babesiosis: Difference between revisions
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==Symptoms== | ==Symptoms== | ||
**Fever, hemolytic anemia, chills, thrombocytopenia, DIC | **[[Fever]], hemolytic anemia, chills, [[thrombocytopenia]], [[DIC]] | ||
**More severe disease in immunocompromized patients (HIV, Elderly, '''Asplenic''') | **More severe disease in immunocompromized patients ([[HIV]], Elderly, '''Asplenic''') | ||
==Diagnosis== | ==Diagnosis== | ||
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**Can often be confused for malaria parasites | **Can often be confused for malaria parasites | ||
== | ==Differential Diagnosis== | ||
{{Tick borne illnesses DDX}} | |||
==Management== | |||
*2 drug regimen for 7-10 days | *2 drug regimen for 7-10 days | ||
Revision as of 20:29, 6 December 2014
Background
- Spread by the deer tick (Ixodes scapularis)
- People often unaware they are bitten
- Natural reservior is the white footed mouse
- Endemic in US, Europe, parts of Russia and China
- Babesia Microti is pathogen in US
Symptoms
- Fever, hemolytic anemia, chills, thrombocytopenia, DIC
- More severe disease in immunocompromized patients (HIV, Elderly, Asplenic)
Diagnosis
- Peripheral blood smear
- Shows intracellular parasites
- Maltese Cross sign
- May need large smear as parasitemia can be as low as 1%
- Can often be confused for malaria parasites
- Shows intracellular parasites
Differential Diagnosis
Tick Borne Illnesses
- Babesiosis
- Colorado tick fever
- Ehrlichiosis
- Heartland virus
- Lyme
- Murine typhus
- Rocky mountain spotted fever
- Southern tick-associated rash illness (STARI)
- Tick paralysis
- Tularemia
Management
- 2 drug regimen for 7-10 days
Option 1
- Atovaquone (750mg BID) and Azithromycin (500-1000mg on first day, 250-1000mg on subsequent days)
Option 2
- Clindamycin 600mg PO q8hrs x 7-10 days (or 300-600mg IV q6hrs)
- Give with Quinine 650mg TID