Abstract
9/L). We found no morulae on microscopic examination of a Wright-stained peripheral blood smear, but suspected that he had human granulocytic anaplasmosis, and started oral doxycycline 100 mg twice daily. Serological testing for antibodies to Anaplasma phagocytophilum was later reported to be positive (>1:80). Routine blood cultures were negative. The patient returned in 1 week without clinical improvement and a platelet count of 1810 9 /L and haemoglobin of 100 mg/L. We repeated the blood smear, and stained it with Giemsa this time, and found plentiful babesia merozoites (figure, top). We started oral clindamycin and quinine.
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