Guideline on Diagnosis and Management of Babesiosis

Publication Date: January 15, 2021

Key Points

Key Points

  • Babesiosis is a disease caused by intraerythrocytic protozoa of the genus Babesia that are transmitted throughout the world by hard-bodied ticks.
    • More than 100 Babesia species infect a wide variety of wild and domestic animals.
      • Babesiosis has long been recognized as an important disease of livestock with significant economic impact in many parts of the world.
    • A subset of Babesia species infect humans.
  • More than 2,000 cases of babesiosis are reported to the CDC annually, but several lines of evidence indicate that the actual number of cases is higher and increasing (Figure 3).
  • Clinical manifestations of babesiosis include fever, fatigue, chills, sweats, headache, and anorexia.
  • Severe babesiosis requires hospital admission and can be complicated by marked anemia, acute respiratory distress syndrome, disseminated intravascular coagulation, congestive heart failure, renal and liver impairment/failure, shock, splenic infarct or rupture, warm autoimmune hemolytic anemia, and/or fatal outcome.
  • A diagnosis should be considered in a patient who resides in or has traveled to an endemic area, experiences clinical symptoms that are consistent with babesiosis, and has characteristic laboratory test abnormalities.
    • The diagnosis is confirmed with the identification of Babesia parasites by microscopic evaluation of blood smears or amplification of Babesia DNA using a polymerase chain reaction (PCR) assay.

Diagnosis

...Diagnosi...

For diagnostic confirmation of acute babesiosis, I...


...ith a positive Babesia antibody test, IDSA...


Treatment

...commends treating babesiosis with the co...


In selected patients with severe babesiosis, I...


...ocompetent patients, IDSA recommends monit...


...ocompromised patients, IDSA suggests monito...


Figure 1. Worldwide Distribution of Human Babesiosis and Tick Vectors

...igure 1. Worldwide Distribution of Human Bab...

Figure 2. Human Babesiosis Occurs Within Lyme Disease Endemic Areas in the United States

...n Babesiosis Occurs Within Lyme Disease End...

Figure 3. Sharp Rise in the Incidence of Babesiosis in the United States in the Past Two Decades

...3. Sharp Rise in the Incidence of Babesiosis i...

Figure 4. Giemsa-stained Thin Blood Films Showing Babesia microti Parasites.

...Giemsa-stained Thin Blood Films Showing...

Table 1. Treatment Regimens for Babesiosis Patients

...ment Regimens for Babesiosis PatientsHaving...