Causative Agent
Babesia microti, Babesia duncani
Type of Organism
Protozoan Species
Length of Attachment for Transmission
36-48 Hours

Initial Symptoms

  • Those infected can be asymptomatic, have flu-like symptoms, or have more severe symptoms.
  • Flu-like symptoms include: Fever, chills, sweats, nausea, vomiting, fatigue.
  • Reduction in platelets, appearance of blood clots, and a decrease in blood pressure can also occur.
  • Severe symptoms are more likely to occur if the infected individual has had their spleen removed, is immunocompromised, or has preexisting liver or kidney conditions.

Diagnosis and Testing

  • Most often, clinical signs and a history of exposure will be the key in diagnosis.
  • An enlarged spleen or liver may be indicate infection and elevated liver enzymes or jaundice may be observed.
  • Visualization of a thin blood smear under a microscope may show hemolytic anemia and active infection of red blood cells by Babesia.
  • Detection of Babesia microti DNA in serum using Polymerase Chain Reaction (PCR) can confirm diagnosis.
  • Indirect fluorescent antibody assay may also be used to detect antibodies specific to Babesia microti.

CDC Treatment Recommendation

  • Adult: Atovaquone 750mg- 2x daily with Azithromycin for 7-10 days or Clindamycin 600mg- 3x daily with Quinine 650mg- 3x daily for 7-10 days.
  • Children: Atovaquone 20mg/kg- 2x daily with Azithromycin for 7-10 days or Clindamycin 7-10mg/kg every 3x daily with Quinine 8mg/kg- 3x daily.

Disease Pathogenesis

Once inside the host, Babesia will invade red blood cells and replicate causing them to rupture and spread into the blood stream. This process destroys the infected red blood cells resulting in a condition known as hemolytic anemia.

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