Babesia is a protozoan that, like Plasmodium species, possesses an erythrocytic phase. It is transmitted by Ixodes ticks and occasionally by blood transfusion. Babesiosis has been reported in the northeastern United States (especially Nantucket, MA, and Long Island, NY). Babesiosis in the northeast is caused by the murine species, Babesia microtti, and is transmitted by the deer tick, Ixodes, which also serves as a vector for Lyme disease. Patients may have intermittent fever, splenomegaly, hemolysis, and jaundice. Infection can be fatal in splenectomized patients, but its incidence is apparently not increased in immunocompromised patients. Diagnosis can be made on a Giemsa-stained peripheral smear. Occasionally, Babesia on smear can be confused with the ring forms of P. falciparum malaria. Babesiosis can simulate rickettsial diseases, such as Rocky Mountain spotted fever and Lyme disease. Treatment is with clindamycin and quinine.
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