Two Cases of Babesia

Severe Babesia microti infection presenting as multiorgan failure in an immunocompetent host.

Ripoll JG, Rizvi MS, King RL, Daniels CE.
BMJ Case Reports, online first 2018 May 30.


A previously healthy 67-year-old farmer presented to an outside hospital after a 2-week history of non-specific respiratory symptoms. A certain diagnosis was not initially apparent, and the patient was discharged home on a regimen for presumed chronic obstructive pulmonary disease exacerbation.

He re-presented to the emergency department with shock and hypoxaemic respiratory failure requiring prompt intubation and fluid resuscitation. He was then transferred to our institution due to multiorgan failure.

On arrival, the patient demonstrated refractory shock and worsening acute kidney injury, severe anaemia and thrombocytopaenia. The peripheral smear revealed absence of microangiopathic haemolytic anaemia. A closer review of the smear displayed red blood cell inclusion bodies consistent with babesiosis.

The patient was started on clindamycin and loaded with intravenous quinidine, and subsequently transitioned to oral quinine. A red cell exchange transfusion was pursued with improvement of the parasite load.

The patient was discharged home on clindamycin/quinine and scheduled for outpatient intermittent haemodialysis.


A Walk in the Park: A Case of Babesiosis in the South Bronx

Hajicharalambous C, Rattu M, Leuchten S.
Clinical Practice and Cases in Emergency Medicine. 2018 Jan 11;2(1):61-63. eCollection 2018 Feb.


Babesiosis, mainly endemic within the Northeastern and upper Midwestern regions of the United States, is a zoonotic disease that invades and lyses red blood cells, which can result in hemolytic anemia. Its decreased incidence in comparison to Lyme disease is often attributed to the greater asymptomatic infection proportion and insufficient physician awareness or suspicion of this disease. Here we describe a case of undifferentiated febrile illness with hemolytic anemia that yielded the diagnosis of babesiosis.



What mainstream medicine as YET to acknowledge and learn is that Lyme patients are typically coinfected with a plethora of pathogens that all demand attention and treatment.  I find the statement in the second abstract telling:  “Its decreased incidence in comparison to Lyme disease is often attributed to the greater asymptomatic infection proportion and insufficient physician awareness or suspicion of the disease.”

What happens in treatment is symptoms disappear one by one only to be replaced by new ones that the patient never noticed before.  My husband and I both had Babesia but didn’t really know it until some of the Lyme symptoms began to abate with treatment.  I was told, and it certainly is true, that treating for tick borne illness is like peeling an onion layer by layer.  This was our exact experience.

Physicians desperately need education on all things TBI as throwing all the doxy in the world at this isn’t going to help many people.  Babesia is a cousin to malaria and requires anti-malarial drugs.  Babesia is also extremely persistent and Dr. Horowitz recommends 9 months to a year of solid treatment.  We treated with Mepron, Arthemisinin (Allergy Research Brand), and an intracellular for a year.  All Babesia symptoms are gone. Dr. Krause published in the New England Journal of Medicine that when a patient has Lyme and Babesia, Lyme is found three-times more frequently in the blood, proving Babesia suppresses the immune system.  It also means you are sicker than a dog.

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