Ver el código de «Babesiosis»

==Background==
*Babesiosis is an infection of the ''Babesia'' species of intraerythrocytic protozoa, causing lysis of host red blood cells.
*Spread by the deer tick (Ixodes scapularis)
**People often unaware they are bitten
*Natural reservior is the white footed mouse
*Endemic in US, Europe, parts of Russia and China
**Babesia Microti is pathogen in US
*Possible to have co-infection with Lyme (same tick family)

==Clinical Features==
*[[Fever]], hemolytic anemia, chills, [[thrombocytopenia]], [[DIC]]
*More severe disease in immunocompromized patients ([[HIV]], Elderly, [[Asplenic]])

==Differential Diagnosis==
{{Tick borne illnesses DDX}}

==Evaluation==
[[File:Maltese_Cross.png|thumb|Peripheral blood smear showing "Maltese Cross" classic for babesiosis.]]
*CBC
**Often with depressed white count
*Peripheral Blood Smears
**Shows intracellular parasites: Maltese Cross sign
**May need large smear as parasitemia can be as low as 1%
**Can often be confused for malaria parasites
*Electrolytes and renal function
*LFTs
**Total bilirubin and haptoglobin values reflect the intensity of the infection (hemolysis)
*Lyme
*Urine - hemolysis
*[[CXR]] - rare but possible ARDS

==Management==
{{Babesiosis Antibiotics}}

==Disposition==
===Admission===
*Severe anemia (hemoglobin <10g/dL)
*Parasitemia >4%
*Mortality risk higher in asplenic patients
===Discharge===
*Parasitemia <4%
*Asymptomatic or mild disease with intact spleen
*Discharged patients should follow-up with primary care or infectious disease specialist

==See Also==
*[[Tick Borne Illnesses]]

==External Links==
*CDC http://www.cdc.gov/parasites/babesiosis/
*[https://www.merckmanuals.com/professional/infectious-diseases/extraintestinal-protozoa/babesiosis Merck Manual - Babesiosis]

==References==
*Tobler WD, Cotton D, Lepore T, Agarwal S, Mahoney EJ. Case Report: Successful non-operative management of spontaneous splenic rupture in a patient with babesiosis. World Journal of Emergency Surgery : WJES. 2011;6:4. doi:10.1186/1749-7922-6-4.
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