Introduction:
Babesiosis is an intra-erythrocytic parasitic infection, transmitted by a tick bite, rarely by blood transfusion and transplacental. Historically, babesiosis is primarily zoonotic medical condition and humans are the incidental host. It is second most common condition transmitted by Ixodes Scapularis. Among several species, B. Microti is the most common specie of babesiosis, prevalent in the Northeastern and upper Midwestern areas of the United States, during the period of June-August. Severity of the infection depends on the immune status of patient and parasitemia (percentage of infected red blood cells). Parasitemia is also one of important criteria for describing the severity and also prognosis. However, to the date there is dearth of literature and pathological specimen exhibiting cases of babesiosis with nearly 100% parasitemia. Therefore, we present one case with such rare features.
Case Description:
An 88 year old female with a significant story of C.Difficile Colitis, secondary to treatment of cellulitis, presented to the emergency department with complain of feeling week, lethargy and diarrhea. She was on treatment of c.difficile colitis. Family added she anxious, agitated and had low oral intake, and denied for any other symptom. …show more content…
On arrival to the hospital, she was unresponsive and in asystole. She responded to CPR and one round of CPR, and started on IV fluids. Her initial lab work gave the picture of severe hemolysis, severe thrombocytopenia, lactic acidosis, severe anion-gap and treatment resistant metabolic acidosis, babesiosis (nearly 100% infected cells on the peripheral blood smear) and acute kidney injury. Recommendations for exchange transfusion and hemodialysis were made. However, after two episodes of cardiac arrest and mild response to the provided treatment, family agreed to code C and comfort measures. Patient went into systole and
Babesiosis is an intra-erythrocytic parasitic infection, transmitted by a tick bite, rarely by blood transfusion and transplacental. Historically, babesiosis is primarily zoonotic medical condition and humans are the incidental host. It is second most common condition transmitted by Ixodes Scapularis. Among several species, B. Microti is the most common specie of babesiosis, prevalent in the Northeastern and upper Midwestern areas of the United States, during the period of June-August. Severity of the infection depends on the immune status of patient and parasitemia (percentage of infected red blood cells). Parasitemia is also one of important criteria for describing the severity and also prognosis. However, to the date there is dearth of literature and pathological specimen exhibiting cases of babesiosis with nearly 100% parasitemia. Therefore, we present one case with such rare features.
Case Description:
An 88 year old female with a significant story of C.Difficile Colitis, secondary to treatment of cellulitis, presented to the emergency department with complain of feeling week, lethargy and diarrhea. She was on treatment of c.difficile colitis. Family added she anxious, agitated and had low oral intake, and denied for any other symptom. …show more content…
On arrival to the hospital, she was unresponsive and in asystole. She responded to CPR and one round of CPR, and started on IV fluids. Her initial lab work gave the picture of severe hemolysis, severe thrombocytopenia, lactic acidosis, severe anion-gap and treatment resistant metabolic acidosis, babesiosis (nearly 100% infected cells on the peripheral blood smear) and acute kidney injury. Recommendations for exchange transfusion and hemodialysis were made. However, after two episodes of cardiac arrest and mild response to the provided treatment, family agreed to code C and comfort measures. Patient went into systole and