Cases were associated with tick bites and receipt of blood products.

Babesiosis is usually acquired from a tick bite or through a blood transfusion. We report a case of babesiosis in an infant for whom vertical transmission was suggested by evidence of Babesia spp. antibodies in the heel-stick blood sample and confirmed by detection of Babesia spp. DNA in placenta tissue.

Objectives: To investigate the association of increased cardiac troponin I levels with in-hospital mortality and valve replacement in patients with infective endocarditis (IE). Methods: The 62 patients included 36 men and 26 women, with a mean age of 60 ± 9 years, with IE diagnosed by the Duke criteria. All 62 patients had blood drawn for measurement of cardiac troponin I levels. A cardiac troponin I level >0.4 ng/ml was considered increased. All 62 patients underwent transesophageal echocardiography. Student’s t tests were used to analyze continuous variables. χ² tests were used to analyze dichotomous variables. Results: Transesophageal echocardiography diagnosed valvular vegetations in 56 of the 62 patients (90%). Cardiac troponin I levels were increased in 35 of the 62 patients (57%). In-hospital mortality or valve replacement occurred in 18 of 35 patients (51%) with increased cardiac troponin I levels versus 4 of 27 patients (15%) with normal cardiac troponin I levels (p < 0.005). Conclusions: Patients with IE and increased cardiac troponin I levels have a higher incidence of in-hospital mortality or valve replacement than those with normal cardiac troponin I levels.

Summary: Sepsis is a major cause of serious morbidity and mortality in pregnant women and their babies. Conventional management has evolved over many years. Improved understanding of the underlying pathophysiology and randomized clinical trials have led to recommendations for the formalization and standardization of the management of severe sepsis in non-pregnant patients. Most of these recommendations are applicable to pregnancy. The Surviving Sepsis Campaign and Early Goal Directed Therapy have relevance to the care of pregnant women with serious infection and are reviewed here.