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


==Diagnosis==
==Diagnosis==

Revisión del 20:29 6 dic 2014

Background

  • 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

Symptoms

Diagnosis

  • Peripheral blood smear
    • 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

Differential Diagnosis

Tick Borne Illnesses

Management

  • 2 drug regimen for 7-10 days

Option 1

  • Atovaquone (750mg BID) and Azithromycin (500-1000mg on first day, 250-1000mg on subsequent days)

Option 2

Clindamycin

  • Clindamycin 600mg PO q8hrs x 7-10 days (or 300-600mg IV q6hrs)
  • Give with Quinine 650mg TID

See Also

Sources