Babeiosis

Causative agent
 Babesia microti 
Reservior
 Rodents are the principal natural reservoir
deer ticks of the family Ixodidae are the usual vectors
Incubation period
 1-2 weeks
Signs and symptoms
Asymptomatic
 Infection may persist for months to years

Symptomatic
 Malaise

 Fatigue

 Chills
Symptoms
 Fever
 Headache
 Myalgia
 Arthralgia which may last for weeks.
 Hepatosplenomegaly with jaundice
 Mild to moderately severe hemolytic anemia
 Mild neutropenia
 Thrombocytopenia
Diagnosis
1. Light microscopy of blood smears
2. Serologic and Polymerase chain reaction-based test

Light microscopy of blood smears

Babesiosis is usually diagnosed by finding Babesia in blood
smears, but differentiation from Plasmodium species can be
difficult. Tetrad forms are unique to Babesia and helpful
diagnostically.
Cont…….
Serologic and polymerase chain reaction-based reactions
 Antibody detection by indirect fluorescent antibody (IFA)

testing using B. microti antigens can be helpful in patients

with low-level parasitemia but may be false –ve in those
infected with other Babesia species.
 PCR-based assays can differentiate Babesia from Plasmodium

falciparum , confirm infection in patients with low parasitemia

identify the Babesia species.
Treatment
a. Atovaquone 750 mg orally (12 hour)
+Azithromycin 500 - 1000 mg orally first day
followed by a daily dose of 250 to 1000 mg
b. Quinine 650 mg orally 3 times a day+
Clindamycin 600 mg orally 3 times a day or 300 to
600 mg IV 4 times a day for 7 to 10 days can also
be used
Differential diagnosis
Differential diagnosis
Ehrlichosis
Causative agent
 Ehrlichia

Signs and symptoms

 Headache

 Muscle aches

 Fatigue

 Toxic shock
Cont……..

 Nausea
 Vomiting
 Diarrhea
 Loss of appetite
 Joint pain
 Confusion
 Rash
 Cough
Macroscopic examination
Diagnosis
 An initial diagnosis is based on the patient’s symptoms and
laboratory tests
 Routine laboratory results include a low white blood cell
count, low platelet count and elevated liver enzymes (ALT,
AST, LDH)
 A confirmed diagnosis can be made using an antibody IFA
(Immuno-Fluorescent Assay) after 21 days of suspected
infection
 In severe cases, blood smears can be examined for ehrlichosis
Microscopic examination
Treatment
 Doxycycline , Minocycline are the drugs of choice
 For people allergic to antibiotics of the tetracycline class, 
rifampin is an alternative
 Early clinical experience suggested that chloramphenicol may
also be effective
Differential diagnosis
Hemobartonellosis
Causative agent
 Haemobartonella felis

Transmission
 Fleas and ticks
Signs and symptoms
  Depression
 Loss of appetite
 Dehydration.
 If severe, anemia could result in weight loss
 Pale mucous membranes
 Weakness
 Fast heart
 Fast respiratory rates
 Jaundice
 Death
Diagnosis
 PCR
 Blood smear
Differential diagnosis
Microscopic examination
Treatment
 Tetracycline
 Oxytetracycline
 Doxycyclin
 Given for three weeks
Thanks