Neonatal Babesiosis

Abstract

A case of transfusion-associated neonatal babesiosis is presented. Jaundice, hepatosplenomegaly, anemia and conjugated hyperbilirubinemia developed in this preterm infant. The diagnosis was eventually made by blood smear, serology and polymerase chain reaction. The patient was treated with clindamycin and quinine and made a favorable recovery. Of neonatal babesiosis reported in the literature, 9 other cases are reviewed, including 6 that were transfusion-associated, 2 congenital and 2 tick transmitted.

Expression, Purification, and Biological Characterization of Babesia microti Apical Membrane Antigen 1

“…Human cases have been reported throughout the world, including the United States, where it is endemic in the northeast and upper Midwest, and Europe, Asia, and Australia (2,3). Babesia usually are transmitted by Ixodes ticks but may be transmitted also by blood transfusion and transplacentally (4)(5)(6). Babesia microti is the primary cause of babesiosis, with an increase in incidence in many areas of the United States of up to 4-fold to 20-fold in the last decade.…”

Probable Congenital Babesiosis in Infant, New Jersey, USA

“…The illness ranged from no symptoms in 2 infants transfused with contaminated blood (8) to symptomatic disease (as in our infant) with fever and hepatosplenomegaly in 5 of 7 (71%), hemolytic anemia in 8 of 10 (80%), indirect hyperbilirubinemia in 4 of 5 (80%), and thrombocytopenia in 7 of 9 (78%) (5). Five of 8 (63%) patients required erythrocyte transfusion (5). The infant we describe had all of these manifestations as well as a higher parasite count than described previously (5).…”

“…Five of 8 (63%) patients required erythrocyte transfusion (5). The infant we describe had all of these manifestations as well as a higher parasite count than described previously (5). Clearly, the spectrum of neonatal babesiosis is variable and must be more fully elucidated, as must determinants of the illness's clinical course and parasite clearance.…”

“…The 2 congenital cases (3,4) are compared to our probable congenital case ( Table 2). All 10 of the affected neonates were reported to have <9% parasitemia (5). The illness ranged from no symptoms in 2 infants transfused with contaminated blood (8) to symptomatic disease (as in our infant) with fever and hepatosplenomegaly in 5 of 7 (71%), hemolytic anemia in 8 of 10 (80%), indirect hyperbilirubinemia in 4 of 5 (80%), and thrombocytopenia in 7 of 9 (78%) (5).…”

Babesia venatorumInfection in Child, China

“…Previously reported babesiosis cases in children have been mostly acquired by blood transfusion ( 10 ). The patient had no history of transfusions with blood products and had never traveled outside his home town before disease onset.…”