Summary
Definition
History and exam
Other diagnostic factors
- constitutional symptoms
- pyrexia
- jaundice
- hepatosplenomegaly
- petechiae, splinter haemorrhages, or ecchymoses
- dark urine
- conjunctival injection
- cough
- sore throat
- photophobia
Risk factors
- residence in or travel to an endemic region
- exposure to Ixodes scapularis ticks
- blood transfusion
- asplenia
- immunosuppression
- age >50 years
- Lyme disease
- human granulocytic anaplasmosis
- maternal infection during pregnancy
Diagnostic investigations
1st investigations to order
- peripheral blood smear (Giemsa or Wright stained)
- FBC
- serum creatinine and urea
- LFTs
- urinalysis
- ELISA and/or immunofluorescence assay for Lyme disease
- polymerase chain reaction and/or immunofluorescence assay for human granulocytic anaplasmosis
Investigations to consider
- polymerase chain reaction for babesial DNA
- indirect immunofluorescence antibody assay for Babesia microti
- IgG/IgM immunoblot for Lyme disease
- HIV serology
- rodent inoculation
Treatment algorithm
Contributors
Authors
Assistant Professor
Department of Medicine
Division of Infectious Diseases and Immunology
New York University School of Medicine
New York
NY
Disclosures
SH declares that she has no competing interests.
Professor of Medicine
Division of Infectious Diseases
Professor of Pathology
Division of Parasitology and Tropical Medicine
Albert Einstein College of Medicine
Bronx
NY
Disclosures
LW has received grant funding from the National Institute of Allergy and Infectious Diseases. He is also the author of references cited in this topic.
Peer reviewers
Professor
Department of Environmental Resource Management
University College Dublin
Belfield
Dublin
Republic of Ireland
Disclosures
JG declares that he has no competing interests.
Associate Professor of Biomedical Sciences
Division of Infectious Diseases
Cummings School of Veterinary Medicine
Tufts University
Boston
MA
Disclosures
ST has active research funding from the NIH. ST is an author or co-author of numerous primary publications on the biology of babesiosis, as well as reviews that have been referenced in this topic.
Professor of Medicine and Microbiology/Immunology
Chief of Allergy, Immunology and Rheumatology
New York Medical College
Valhalla
NY
Disclosures
RJD declares that he has no competing interests.
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