Failure of Lyme disease treatment - Investigate for babesiosis

USA: Delayed diagnosis is common in patients with babesiosis, this is because almost half of the patients with the condition do not recall being bitten by a tick -- are the findings of a recent study published in the journal Open Forum Infectious Diseases.

Babesiosis, caused by a tick-borne parasite that infects red blood cells, is an emerging health risk and clinicians need to be aware of its different clinical manifestations. While mainly transmitted by ticks, rare cases have been reported following blood transfusion or solid organ transplantation. There are multiple Babesia species that cause human disease including B. microti, B. divergens, B. duncani, and B. venatorum.

Madiha Fida, Division of Infectious Diseases, Department of Internal Medicine Mayo Clinic, Rochester, MN, and colleagues describe the largest series of midwestern patients with babesiosis to date based on our institutional experience over a 14 year period.

For the purpose, they analyzed 38 cases of babesiosis diagnosed in patients in Minnesota and Wisconsin from 2005 to 2017.

Key findings of the study include:

• No patients died, but 68% required hospitalization, and 21% were admitted to the intensive care unit.


• Co-infection with other tick-borne pathogens was fairly common in the 38 patients: 28.9% of patients also had Lyme disease and 10.5% had Anaplasma infection.


• Co-infections were correlated with more severe symptoms.


• The diagnosis was most often made in the summer months, peaking in July.


• Patients were usually diagnosed more than 2 weeks after symptom onset.

"The majority of patients who become infected are asymptomatic and never present for care," the authors concluded. "Due to the non-specific symptoms of babesiosis, diagnosis is often delayed…. In patients with a diagnosis of Lyme disease or Anaplasmosis, if there is no improvement after initiation of therapy, babesiosis should be suspected."

To read the complete study log on to https://doi.org/10.1093/ofid/ofz311