Emerging Epidemics of Babesiosis in Hematology Consultation at a University Hospital.

Abstract

Babesiosis was first reported in NY in 1975. 560 cases were reported from 1986–2001 in NY, mostly from Long island. Human babesiosis is a tick- borne disease caused by B.microti in the US. Most of the cases occur between May and August in the north eastern states. The risk factors for severe disease include older age, asplenia, immunocompromised state. As the same tick is the vector for lyme disease and ehrlichiosis, co-infection can occur. In this abstract we report ten cases of babesiosis encountered in hematology consultation since 2005, with 5 cases occurring this year. The patients' ages ranged between 36–84 yrs. Three patients had neither travel history nor tick bite /outdoor activity. Three patients were immunocompromised (AML, CLL, HIV). Most common presentations were malaise, nausea, and high fever. Two patients had splenomegaly. Six patients had hyperbilirubinemia, anemia and thrombocytopenia. Three patients were also positive for lyme disease. One patient developed splenic rupture. All the patients recovered after treatment with atovoquone and azithromycin. This series of case reports emphasizes the varied atypical presentations of babesioisis including uncommon season of occurrence, absence of a rash or tickbite history, co-existing infection with Lyme disease and complications including splenic rupture.