Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
Other diagnostic factors
- síntomas constitucionales
- pirexia
- ictericia
- hepatoesplenomegalia
- petequias, hemorragias en astilla o equimosis
- orina oscura
- inyección conjuntival
- tos
- dolor de garganta
- fotofobia
Risk factors
- zonas endémicas: residencia o viajes
- exposición a garrapatas Ixodes scapularis
- transfusión de sangre
- asplenia
- inmunosupresión
- >50 años de edad
- Enfermedad de Lyme
- anaplasmosis granulocítica humana
- infección de la madre durante el embarazo
Diagnostic tests
1st tests to order
- frotis de sangre periférica (preparados con tinción de Giemsa o Wright)
- reacción en cadena de la polimerasa para el ADN de babesiosis
- hemograma completo (HC)
- creatinina sérica y urea
- pruebas de función hepática (PFH)
- análisis de orina
- ensayo de inmunoadsorción enzimática (ELISA) y/o prueba de inmunofluorescencia para la enfermedad de Lyme
- reacción en cadena de la polimerasa y/o prueba de inmunofluorescencia o frotis de capa leucocitaria para la anaplasmosis granulocítica humana
Tests to consider
- prueba de anticuerpos por inmunofluorescencia indirecta para Babesia microti
- ensayo de inmunotransferencia de IgG/IgM para la enfermedad de Lyme
- serología del virus de la inmunodeficiencia humana (VIH)
Treatment algorithm
infección asintomática documentada
enfermedad leve a moderada
enfermedad grave aguda
enfermedad recurrente o refractaria
Contributors
Authors
Sarah Hochman, MD
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.
Louis Weiss, MD, MPH
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
Jeremy Gray, BSc, MSc, PhD
Professor
Department of Environmental Resource Management
University College Dublin
Belfield
Dublin
Republic of Ireland
Disclosures
JG declares that he has no competing interests.
Sam Telford III, ScD
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.
Raymond J. Dattwyler, MD
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Vannier E, Krause PJ. Human babesiosis. N Engl J Med. 2012;366:2397-2407. Abstract
Centers for Disease Control and Prevention. Tickborne diseases of the United States: a reference manual for health care providers, sixth edition. Aug 2022 [internet publication].Full text
Krause PJ, Auwaerter PG, Bannuru RR, et al. Clinical practice guidelines by the Infectious Diseases Society of America (IDSA): 2020 guideline on diagnosis and management of Babesiosis. Clin Infect Dis. 2021 Jan 27;72(2):e49-e64.Full text Abstract
Sanchez E, Vannier E, Wormser GP, et al. Diagnosis, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: a review. JAMA. 2016;315:1767-77. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Enfermedad de Lyme
- Anaplasmosis granulocítica humana
- Fiebre maculosa de las Montañas Rocosas
More DifferentialsGuidelines
- Tickborne diseases of the United States: a reference manual for health care providers
- 2020 guideline on diagnosis and management of Babesiosis
More GuidelinesPatient information
Enfermedad de Lyme
Prevención de la malaria
More Patient information
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